Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

One-lung ventilation (OLV) is a common practice during thoracic surgery; however it can induce hypoxemia, lung injury, and release of inflammatory mediators by different mechanisms. Volume-controlled ventilation (VCV) has been considered the conventional approach to mechanical ventilation during OLV; however, recently pressure-controlled ventilation (PCV) has gained interest due to its potential advantages. The aim of this study was to compare between PCV and VCV during OLV as regards oxygenation, lung mechanics and lung injury. We studied 50 patients scheduled for thoracic surgery with OLV in the lateral decubitus position. After initial two-lung ventilation with VCV, patients were randomly assigned to one of two groups; in the first group OLV was achieved with PCV (inspiratory pressure to provide a tidal volume of 6 mL/kg), and in the second group OLV was achieved with VCV (tidal volume 6 mL/kg). Lung mechanics and blood gases were measured at different times throughout the procedure and 2 bronchoalveolar lavage (BAL) samples were obtained from the ventilated lung for measurement of IL-6, one before, and the second 30 minutes after OLV. There were no significant differences in the measured parameters between both groups during OLV, apart from SaO2 that was significantly lower in VCV group. Peak airway pressure, mean airway pressure, and PaCO2 were significantly increased during OLV in both groups. Dynamic lung compliance and PaO2 were significantly increased during OLV in both groups

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