Echocardiographic Evaluation of the Change on Pulmonary Blood Flow and Cardiac Function During One-lung Ventilation

Yonsei University25 enrolled

Overview

The investigators used transesophageal echocardiography (TEE) to assess the change of pulmonary blood flow and bi-ventricular function during lung isolation. The investigators hypothesized that changes in pulmonary venous flow with lung isolation may be related the shunt fraction and oxygenation during one lung ventilation (OLV). The investigators also observed the cardiac function during two lung ventilation (TLV) and OLV in supine and lateral position by TEE.

Study Type

INTERVENTIONAL

Allocation

Masking

NONE

Enrollment

Conditions

Video-assisted Thoracic Surgery

Interventions

transesophageal echocardiography(TEE)PROCEDURE

Transesophageal echocardiography examination will be performed TLV in supine and lateral position, 10, 20 and 30 min during OLV in left lateral decubitus position. By using the transesophageal echocardiography, we will evaluate the changes of pulmonary blood flow and cardiac function.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Above 20 years of age. * American Society of Anesthesiologists (ASA) Physical Status I and II * Thoracic surgical procedure (video-assisted) Exclusion Criteria: * severe functional liver or kidney disease * cardiac disease * arrhythmia * exceed BMI \> 30 kg/ m2 * COPD * pathologic esophageal lesion (esophageal stricture or varix ) * pregnancy

Locations (1)

Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine

Seoul, South Korea

Outcomes

Primary Outcomes

The change of pulmonary blood flow

Pulmonary blood flow = PVA(cross sectional area of LUPV) x VTI(velocity time integral) x HR , Fractional area change = \[(LVAd-LVAs)/LVAd\] × 100 Ejection fraction = \[(LVEDV(LV end-diastolic volume) -LVESV(LV end-systolic volume)/LVEDV\] × 100

Time frame: two-lung ventilation in the supine (T1) and lateral position (T2) and 10 (T3), 20 (T4), and 30 min (T5) during OLV in the left lateral decubitus position.

Secondary Outcomes

The changes of respiratory parameters

shunt fraction Qs/Qt = (CcO2- CaO2)/(CcO2- CvO2) CcO2 = Hgb x 1.34 x ScO2 + PcO2 x 0.003, lung compliance : Compliance= Vt / Pplat, physiologic dead space : Vd/Vt = 1.14 x (PaCO2 - PETCO2)/PaCO2- 0.005

Time frame: two-lung ventilation in the supine (T1) and lateral position (T2) and 10 (T3), 20 (T4), and 30 min (T5) during OLV in the left lateral decubitus position.

The change of cardiac function

Time frame: two-lung ventilation in the supine (T1) and lateral position (T2) and 10 (T3), 20 (T4), and 30 min (T5) during OLV in the left lateral decubitus position.

Data from ClinicalTrials.gov

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