• Shunsuke Fujii, Mutsuhito Kikura, Tomosue Takada, Shigeru Katoh, Nao Aoyama, and Shigehito Sato.
• Department of Anesthesiology and Pain Clinic, Seirei-Mikatabara General Hospital, Hamamatsu, Japan.
• J Clin Anesth. 2004 Aug 1;16(5):347-52.

Study ObjectivesTo test the hypothesis that effective pulmonary capillary blood flow can be a useful indicator for estimating appropriate oxygenation and ventilation during one-lung ventilation in lung surgery.DesignProspective data analysis.SettingA 770-bed general teaching hospital.Patients15 ASA physical status II and III patients undergoing elective lung surgery.InterventionsPatients received general and thoracic epidural anesthesia and underwent lung operation with one-lung ventilation.MeasurementsWe measured effective pulmonary capillary blood flow by a partial CO2 rebreathing method and oxygenation parameters during two-lung ventilation before surgery, during one-lung ventilation, and during two-lung ventilation after lung surgery.Main ResultsThe effective pulmonary capillary blood flow index significantly decreased by 31.6%, which was associated with a significant decrease in arterial oxygen tension (PaO2). The pulmonary shunt fraction increased to 46.3% during one-lung ventilation. During two-lung ventilation, after chest closure, effective pulmonary capillary blood flow index divided by heart rate (i.e., effective pulmonary blood stroke flow index) was still significantly lower than that seen during two-lung ventilation before thoracotomy. There were significant correlations between effective pulmonary capillary blood flow, pulmonary blood stroke flow index, and PaO2.ConclusionsEffective pulmonary capillary blood flow index and effective pulmonary blood stroke flow index are useful indicators for determining appropriate oxygenation therapy during one-lung ventilation.Copyright 2004 Elsevier Inc.

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