Effects of Iloprost on Oxygenation during One-Lung Ventilation in Patients with Low Diffusing Capacity for Carbon Monoxide: A Randomized Controlled Study
The protective mechanism of hypoxic pulmonary vasoconstriction during one-lung ventilation (OLV) is impaired in patients with a low diffusing capacity for carbon monoxide (DL<sub>CO</sub>). We hypothesized that iloprost inhalation would improve oxygenation and lung mechanics in patients...
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/6/1542 |
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| author | Kyuho Lee Young Jun Oh Mina Kim Sei Han Song Namo Kim |
| author_facet | Kyuho Lee Young Jun Oh Mina Kim Sei Han Song Namo Kim |
| author_sort | Kyuho Lee |
| collection | DOAJ |
| description | The protective mechanism of hypoxic pulmonary vasoconstriction during one-lung ventilation (OLV) is impaired in patients with a low diffusing capacity for carbon monoxide (DL<sub>CO</sub>). We hypothesized that iloprost inhalation would improve oxygenation and lung mechanics in patients with low DL<sub>CO</sub> who underwent pulmonary resection. Forty patients with a DL<sub>CO</sub> < 75% were enrolled. Patients were allocated into either an iloprost group (ILO group) or a control group (<i>n</i> = 20 each), in which iloprost and saline were inhaled, respectively. The partial pressure of arterial oxygen/fraction of inspired oxygen (PaO<sub>2</sub>/FiO<sub>2</sub>) ratio, pulmonary shunt fraction, alveolar dead space, dynamic compliance, and hemodynamic parameters were assessed 20 min after the initiation of OLV and 20 min after drug administration. Repeated variables were analyzed using a linear mixed model between the groups. Data from 39 patients were analyzed. After iloprost inhalation, the ILO group exhibited a significant increase in the PaO<sub>2</sub>/FiO<sub>2</sub> ratio and a decrease in alveolar dead space compared with the control group (<i>p</i> = 0.025 and <i>p</i> = 0.042, respectively). Pulmonary shunt, dynamic compliance, hemodynamic parameters, and short-term prognosis were comparable between the two groups. Selective iloprost administration during OLV reduced alveolar dead space and improved oxygenation while minimally affecting hemodynamics and short-term prognosis. |
| first_indexed | 2024-03-09T19:37:13Z |
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| id | doaj.art-18216b0b72d3495484b759e15e00216a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T19:37:13Z |
| publishDate | 2022-03-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-18216b0b72d3495484b759e15e00216a2023-11-24T01:47:56ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01116154210.3390/jcm11061542Effects of Iloprost on Oxygenation during One-Lung Ventilation in Patients with Low Diffusing Capacity for Carbon Monoxide: A Randomized Controlled StudyKyuho Lee0Young Jun Oh1Mina Kim2Sei Han Song3Namo Kim4Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang 10326, KoreaDepartment of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaThe protective mechanism of hypoxic pulmonary vasoconstriction during one-lung ventilation (OLV) is impaired in patients with a low diffusing capacity for carbon monoxide (DL<sub>CO</sub>). We hypothesized that iloprost inhalation would improve oxygenation and lung mechanics in patients with low DL<sub>CO</sub> who underwent pulmonary resection. Forty patients with a DL<sub>CO</sub> < 75% were enrolled. Patients were allocated into either an iloprost group (ILO group) or a control group (<i>n</i> = 20 each), in which iloprost and saline were inhaled, respectively. The partial pressure of arterial oxygen/fraction of inspired oxygen (PaO<sub>2</sub>/FiO<sub>2</sub>) ratio, pulmonary shunt fraction, alveolar dead space, dynamic compliance, and hemodynamic parameters were assessed 20 min after the initiation of OLV and 20 min after drug administration. Repeated variables were analyzed using a linear mixed model between the groups. Data from 39 patients were analyzed. After iloprost inhalation, the ILO group exhibited a significant increase in the PaO<sub>2</sub>/FiO<sub>2</sub> ratio and a decrease in alveolar dead space compared with the control group (<i>p</i> = 0.025 and <i>p</i> = 0.042, respectively). Pulmonary shunt, dynamic compliance, hemodynamic parameters, and short-term prognosis were comparable between the two groups. Selective iloprost administration during OLV reduced alveolar dead space and improved oxygenation while minimally affecting hemodynamics and short-term prognosis.https://www.mdpi.com/2077-0383/11/6/1542one-lung ventilationdiffusing capacity for carbon monoxideiloprostoxygenation |
| spellingShingle | Kyuho Lee Young Jun Oh Mina Kim Sei Han Song Namo Kim Effects of Iloprost on Oxygenation during One-Lung Ventilation in Patients with Low Diffusing Capacity for Carbon Monoxide: A Randomized Controlled Study Journal of Clinical Medicine one-lung ventilation diffusing capacity for carbon monoxide iloprost oxygenation |
| title | Effects of Iloprost on Oxygenation during One-Lung Ventilation in Patients with Low Diffusing Capacity for Carbon Monoxide: A Randomized Controlled Study |
| title_full | Effects of Iloprost on Oxygenation during One-Lung Ventilation in Patients with Low Diffusing Capacity for Carbon Monoxide: A Randomized Controlled Study |
| title_fullStr | Effects of Iloprost on Oxygenation during One-Lung Ventilation in Patients with Low Diffusing Capacity for Carbon Monoxide: A Randomized Controlled Study |
| title_full_unstemmed | Effects of Iloprost on Oxygenation during One-Lung Ventilation in Patients with Low Diffusing Capacity for Carbon Monoxide: A Randomized Controlled Study |
| title_short | Effects of Iloprost on Oxygenation during One-Lung Ventilation in Patients with Low Diffusing Capacity for Carbon Monoxide: A Randomized Controlled Study |
| title_sort | effects of iloprost on oxygenation during one lung ventilation in patients with low diffusing capacity for carbon monoxide a randomized controlled study |
| topic | one-lung ventilation diffusing capacity for carbon monoxide iloprost oxygenation |
| url | https://www.mdpi.com/2077-0383/11/6/1542 |
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