caa a22 4500 445374640 CHVBK 20180317142959.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00540-010-1078-z doi (NATIONALLICENCE)springer-10.1007/s00540-010-1078-z Co-administration of ephedrine prevents reductions in cardiac output and systemic oxygen delivery secondary to lung compression maneuvers during one-lung ventilation, without reducing arterial oxygenation [Elektronische Daten] [Seiji Ishikawa, Fumi Makino, Satomi Kobinata, Hiroyuki Ito, Tatsuyuki Kawano, Koshi Makita] Purpose: We previously showed that compression of the nondependent lung during one-lung ventilation (OLV) in patients undergoing esophagectomy improves arterial oxygenation but impairs cardiac output (CO) and systemic oxygen delivery (DO2). The objective of this study was to test the hypothesis that the combination of nondependent lung compression and ephedrine improves arterial oxygenation without compromising DO2. Methods: Twenty patients undergoing esophagectomy through a right thoracotomy were studied. Under general anesthesia, a left-sided double-lumen tube was placed, and the dependent lung was mechanically ventilated with a tidal volume of 8ml/kg and a fraction of inspiratory oxygen of 0.8 during OLV. When nondependent lung was compressed by surgeons to improve surgical exposure, a randomly determined intravenous bolus of either ephedrine 4mg (group E) or an identical volume of saline (group S) was administered. Arterial blood was sampled during two-lung ventilation (TLV), at 10min of OLV (OLV1), and 5min after nondependent lung compression (OLV2). Results: The initiation of OLV resulted in a significant drop in PaO2 at OLV1 (group E, 136±69mmHg; group S, 138±83mmHg; P<0.01) compared with TLV (group E, 404±44mmHg; group S; 367±51mmHg) and tended to improve at OLV2 (group E, 170±63mmHg; group S; 196±121mmHg). However, although CO and DO2 significantly decreased in group S at OLV2 (4.0±0.8l/min, 621±116ml/min; P<0.01) compared with OLV1 (5.1±0.7l/min, 811±140ml/min), there was no significant difference in these parameters in group E for the two time points. Conclusion: Although arterial oxygenation was not significantly improved by the nondependent lung compression, the addition of intravenous ephedrine to nondependent lung compression prevented the decrease in systemic oxygen delivery without deterioration of arterial oxygenation during OLV in patients undergoing esophagectomy. Japanese Society of Anesthesiologists, 2010 One-lung ventilation nationallicence Esophagectomy nationallicence Ephedrine nationallicence Nondependent lung nationallicence Ishikawa Seiji Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut Makino Fumi Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut Kobinata Satomi Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut Ito Hiroyuki Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut Kawano Tatsuyuki Department of Surgery, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan aut Makita Koshi Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut Journal of Anesthesia Springer Japan 25/2(2011-04-01), 163-169 0913-8668 25:2<163 2011 25 540 https://doi.org/10.1007/s00540-010-1078-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-010-1078-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ishikawa Seiji Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut NATIONALLICENCE 700 1- Makino Fumi Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut NATIONALLICENCE 700 1- Kobinata Satomi Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut NATIONALLICENCE 700 1- Ito Hiroyuki Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut NATIONALLICENCE 700 1- Kawano Tatsuyuki Department of Surgery, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan aut NATIONALLICENCE 700 1- Makita Koshi Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/2(2011-04-01), 163-169 0913-8668 25:2<163 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer