Background: Previously a report has suggested that administration of lung protective
strategy for one-lung ventilation (OLV) results in oxygen desaturation of the brain
parenchyma. The aim of our work was to confirm that the maintenance of normocapnia
during protective OLV strategy results in alteration of cerebral blood flow and cerebral
oxygen saturation as compared to double-lung ventilation. Methods: Data were obtained
from 24 patients undergoing thoracic surgery. Cerebral oxygen saturation (rSO(2))
was continuously monitored by INVOS 5100C Cerebral Oxymeter System along with measurement
of cerebral blood flow velocity (MCAV) by transcranial Doppler sonography. Arterial
blood samples were taken for blood gas analysis in the awake state, in the supine
and lateral decubitus position during double-lung ventilation (DLV), and during OLV.
Results: When ventilation was changed from DLV to OLV, no significant change was observed
in rSO(2). A significant decrease of rSO(2) was found compared to the value observed
during DLV in lateral decubitus at the time point 60 minutes after the start of OLV.
No clinically significant changes in the MCAV was observed throughout the course of
the thoracic surgical procedure. Conclusions: OLV does not result in clinically relevant
decreases in cerebral blood flow and cerebral oxygen saturation during application
of lung protective ventilation if normocapnia is maintained.
