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January 1, 2003Korean Journal of AnesthesiologyOpen Access

Effects of Desflurane and Isoflurane on Arterial Oxygenation and Hemodynamics during One-lung Ventilation

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Why the study?

Does desflurane compared to isoflurane improve arterial oxygenation and hemodynamics during one-lung ventilation in patients undergoing CABG?

Population

35 patients scheduled for coronary artery bypass graft with stable or unstable angina, ASA physical status…

Comparison

Desflurane administered during one-lung… vs Isoflurane administered during one-lung…

Design

RCT, randomly assigned to one of group D/I and I/D

Follow-up

Intraoperative (up to 120 minutes across 4 steps)

Authors

JSJin Woo ShinCancer Prevention Institute of CaliforniaKHKyung Don HamCBChong Wha BaekChung-Ang University Hospital

Discussion

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Implication

Desflurane offers no oxygenation advantage over isoflurane during one-lung ventilation; warrants caution in CABG patients due to increased pulmonary pressures.

Structured PICO

Does desflurane compared to isoflurane improve arterial oxygenation and hemodynamics during one-lung ventilation in patients undergoing CABG?

P
Population
35 patients scheduled for coronary artery bypass graft (CABG) with stable or unstable angina, ASA physical status II or III, normal pulmonary function, no hypoxia or hypercapnia on room air, and ejection fraction >50%.
I
Intervention
Desflurane (end-tidal concentration 6% in 93% oxygen) administered during one-lung ventilation for 30 minutes.
C
Comparator
Isoflurane (end-tidal concentration 1.2% in 93% oxygen) administered during one-lung ventilation for 30 minutes in a crossover design.
O
Outcome
Arterial oxygenation (PaO2) and hemodynamics (mean pulmonary arterial pressure, pulmonary capillary wedge pressure) at the end of 30 minutes of one-lung ventilation.surrogate

Desflurane and isoflurane provide similar arterial oxygenation during one-lung ventilation, but desflurane should be used with caution in ischemic heart disease due to its potential to increase pulmonary pressures.

Limitations

  • Supine position during one-lung ventilation may have increased pulmonary shunt compared to lateral decubitus position
  • Long duration of the 4-step experimental process

Cite This Study

Shin et al. (2003) studied this question.

synapsesocial.com/papers/6a9018f04ca7c096eec90bb7https://doi.org/10.4097/kjae.2003.44.2.201
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiovascular effects of desflurane and isoflurane in patients with coronary artery disease1996 · 20 citations
  2. 2Preservation of Hypoxic Pulmonary Vasoconstriction during Sevoflurane and Desflurane Anesthesia Compared to the Conscious State in Chronically Instrumented Dogs 1998 · 34 citations
  3. 3Comparison of Emergence and Recovery Characteristics of Sevoflurane, Desflurane, and Halothane in Pediatric Ambulatory Patients1996 · 267 citations
  4. 4Solubility of I-653, Sevoflurane, Isoflurane, and Halothane in Human Tissues1989 · 256 citations
  5. 5Effects of Halothane, Enflurane, and Isoflurane on Hypoxic Pulmonary Vasoconstriction in Rat Lungs In Vitro1984 · 114 citations