Effects of combined one-lung ventilation and intrathoracic carbon dioxide insufflation on intrathoracic working space when performing thoracoscopy in dogs

Author:

Kanai Eiichi1,Matsutani Noriyuki12,Watanabe Ryota3,Yamamoto Yasuto4,Sakai Takashi1,Misumi Toshihiro5,Fujii Yoko1,Takagi Satoshi1

Affiliation:

1. Laboratory of Small Animal Surgery, School of Veterinary Medicine, Azabu University, Kanagawa, Japan

2. Teikyo University Hospital Mizonokuchi, Kanagawa, Japan

3. Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada

4. Department of Cardiovascular Surgery, School of Medicine, Teikyo University, Tokyo, Japan

5. Department of Biostatistics, School of Medicine, Yokohama City University, Yokohama, Japan

Abstract

Abstract OBJECTIVE To evaluate the effects of combining one-lung ventilation and carbon dioxide insufflation (OLV-CDI) on intrathoracic working space (determined by means of CT) during thoracoscopy in dogs and investigate conditions that could safely improve working space compared with OLV alone. ANIMALS 6 healthy Beagles. PROCEDURES Dogs were anesthetized, and right- or left-sided (n = 3/side) OLV was instituted. On the blocked side, a laparoscopic trocar sleeve was placed in the ninth intercostal space for CDI. CT was performed under 3 conditions: with OLV alone, with OLV-CDI at an intrapleural pressure (IPP) of 3 mm Hg, and with OLV-CDI at an IPP of 5 mm Hg. Working space volume (WSV), ventilation space volume (VSV), and thoracic cavity volume (TCV) were determined from CT images. RESULTS With OLV-CDI at an IPP of 3 or 5 mm Hg, WSV and TCV were significantly increased, compared with values obtained during OLV alone. With OLV-CDI at an IPP of 5 mm Hg, VSV and Spo2 were significantly decreased, compared with values obtained during OLV alone. Additionally, contralateral pneumothorax was observed in 4 dogs at an IPP of 5 mm Hg. CLINICAL RELEVANCE Combining OLV and CDI could provide a larger working space than OLV alone, even with an IPP of 3 mm Hg, in dogs of limited size. However, an evaluation of the effects on oxygenation and cardiovascular variables is needed before clinical use.

Publisher

American Veterinary Medical Association (AVMA)

Subject

General Veterinary,General Medicine

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