This study investigates the effects of three extrinsic PEEP settings-5 cmH2O, 0 cmH2O, and an individualized PEEP (70% of the measured intrinsic PEEP)-on intrinsic PEEP and hemodynamic stability in patients with intrinsic PEEP undergoing lung resection surgery, using a randomized, crossover design.
American Society of Anesthesiologists Physical Status I - III
The Eastern Cooperative Oncology Group Performance Status Grade 0 - 2
Lung resection surgery requiring one-lung ventilation for over 60 minutes
Indication of double-lumen endobronchial tube (female 35 Fr, male 37 Fr)
Large bullae
Emergency surgery
Mechanical ventilation before surgery
Hemodynamic instability before surgery
Single group
PEEP0
Procedure/SurgeryPEEP 0 (zero) means off-PEEP on the anesthesia machine.
PEEP5
Procedure/SurgeryPEEP5 means setting the PEEP to 5 cmH2O on the anesthesia machine.
PEEPi
Procedure/SurgeryPEEPi (individualized PEEP) means setting the PEEP to 70% of intrinsic PEEP on the anesthesia machine.
Intrinsic positive end-expiratory airway pressure
During one-lung ventilation, each patient will randomly receive three PEEP interventions: 0 cmH2O, 5 cmH2O, and the 70% value of intrinsic PEEP. After each 5-minute intervention, intrinsic PEEP will be measured by the anesthesia machine.
Stroke volume
During one-lung ventilation, each patient will randomly receive three PEEP interventions: 0 cmH2O, 5 cmH2O, and the 70% value of intrinsic PEEP. After each 5-minute intervention, Stroke volume will be measured by an arterial pressure-based cardiac output monitor.
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