British Journal of Anaesthesia, Vol 82, Issue 2 208-212, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
K. Fradj, E. Samain, D. Delefosse, E. Farah and J. Marty
The aim of this prospective, placebo-controlled study was to assess if
unilaterally inhaled nitric oxide 20 ppm could treat hypoxaemia during
one-lung ventilation. Sixty patients undergoing pulmonary resection using a
lateral thoracotomy were allocated randomly to a control or nitric oxide
group (NO group). During one-lung ventilation in the lateral decubitus
position, the lungs were ventilated mechanically with 90% oxygen--10%
nitrogen. After randomization, if PaO2 decreased to less than 9.3 kPa
during one-lung ventilation, nitric oxide 20 ppm or nitrogen was added to
the inspired gas. The criterion for treatment efficacy was an increase in
PaO2 to greater than 9.3 kPa after gas administration. Eight patients in
the control group and eight in group NO experienced hypoxaemia during
one-lung ventilation. PaO2 was not significantly different in the two
groups at the time of gas administration (control group mean 8.0 (SD 0.6)
kPa; NO group 8.5 (0.5) kPa). The efficacy criterion was reached in two of
eight patients in the control and NO groups. The results of this study
showed that inhaled nitric oxide 20 ppm, administered in the dependent
lung, was not superior to nitrogen in the treatment of hypoxaemia during
one-lung ventilation. Nitric oxide should not be recommended as an
alternative to conventional management of hypoxaemia in this condition.
CLINICAL INVESTIGATIONS
Placebo-controlled study of inhaled nitric oxide to treat hypoxaemia during one-lung ventilation
UFR Xavier Bichat, Universite Paris VII, Service d'Anesthesiologie, Hopital Beaujon, 100 Bvd General Leclerc, F-92110 Clichy, France; Service d'Anesthesiologie, Hopital Beaujon, 100 Bvd General Leclerc, F-92110 Clichy, France
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