• Sung Yong Park, Dae Hee Kim, Jin Soo Kim, Sung Soo Lee, and Yong Woo Hong.
• Department of Anesthesiology and Pain Medicine, Ajou University of College of Medicine, Suwon, Korea.
• J. Thorac. Cardiovasc. Surg. 2010 Jun 1;139(6):1436-40.

ObjectiveHypoxemia is a common problem of 1-lung ventilation. Arterial oxygenation progressively decreases after 1-lung ventilation. The surgical position influences the shunt and arterial oxygenation. Therefore we evaluated the effect of head-up tilt on intrapulmonary shunt and oxygenation during 1-lung ventilation in the lateral decubitus position.MethodsTwenty patients requiring 1-lung ventilation were included in this study. During 1-lung ventilation, hemodynamic and respiratory variables were measured 15 minutes after horizontal positioning in the lateral decubitus position (baseline), 5 and 10 minutes after a 10-degree head-up tilt (T5 and T10, respectively), and 10 minutes after the patient was returned to a horizontal position (T20). Arterial and mixed venous blood analyses were performed at the same time points.ResultsArterial oxygenation was increased, and shunt was decreased significantly during head-up tilt position in 1-lung ventilation. These changes were accompanied by decreases in the mean arterial pressure and cardiac filling pressures without significant changes in cardiac index.ConclusionsHead-up tilt during 1-lung ventilation in the lateral decubitus position caused a significant decrease in shunt and an increase in arterial oxygenation that persisted after the patient was returned to the horizontal lateral decubitus position.Copyright 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

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