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GENERAL ARTICLES

The Effects of Increasing Concentrations of Desflurane on Systemic Oxygenation During One-Lung Ventilation in Pigs

Waheedullah Karzai, MD^*, Jörg Haberstroh, VMD, and Hans-Joachim Priebe, MD^*

Departments of *Anesthesia and Surgical Research, University Hospital Freiburg, Freiburg, Germany

Address correspondence and reprint requests to W. Karzai, MD, Department of Anesthesia, University Hospital, 07740 Jena, Germany. Address e-mail to karzai{at}anae1.med.uni-jena.de

During one-lung ventilation (OLV), hypoxic pulmonary vasoconstriction reduces venous admixture and attenuates the decrease in arterial O₂ tension by diverting blood from the nonventilated to the ventilated lung. In vitro, increasing concentrations of desflurane depresses hypoxic pulmonary vasoconstriction in a dose-dependent manner. Accordingly, we investigated the effects of increasing concentrations of desflurane on oxygenation during OLV in vivo. Thirteen pigs (25–30 kg) were anesthetized (induction: propofol 2–3 mg/kg IV;maintenance: N₂O/O₂ 50%/50%, desflurane 3%, propofol 50 µg · kg^-1 · min^-1, and vecuronium 0.2 mg · kg^-1 · h^-1 IV), orotracheally intubated, and mechanically ventilated. After placement of femoral arterial and thermodilution pulmonary artery catheters, a left-sided, 28F, double-lumen tube was placed via tracheotomy. After double-lumen tube placement, N₂O and desflurane were discontinued, propofol was increased to 200 µg · kg^-1 · min^-1, and the fraction of inspired oxygen was adjusted at 0.8. Anesthesia was then continued in random order with desflurane 5%, 10%, or 15% end-tidal concentrations while propofol was discontinued. Whereas mixed venous PO₂, mean arterial pressure, cardiac output, and shunt fraction decreased in a dose-dependent manner, PaO₂ remained unchanged with increasing concentrations of desflurane during OLV. These findings indicate that, in vivo, increasing concentrations of desflurane do not necessarily worsen oxygenation during OLV.

Implications: Oxygenation during one-lung ventilation depends on reflex vasoconstriction in the nonventilated lung. In vitro, desflurane inhibits this reflex dose-dependently. Our results indicate that, in vivo, this does not necessarily translate to dose-dependent decreases in oxygenation during one-lung ventilation.

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