@article{JTD15690,
author = {Shugeng Gao and Zhongheng Zhang and Alessandro Brunelli and Chang Chen and Chun Chen and Gang Chen and Haiquan Chen and Jin-Shing Chen and Stephen Cassivi and Ying Chai and John B. Downs and Wentao Fang and Xiangning Fu and Martínez I. Garutti and Jianxing He and Jie He and Jian Hu and Yunchao Huang and Gening Jiang and Hongjing Jiang and Zhongmin Jiang and Danqing Li and Gaofeng Li and Hui Li and Qiang Li and Xiaofei Li and Yin Li and Zhijun Li and Chia-Chuan Liu and Deruo Liu and Lunxu Liu and Yongyi Liu and Haitao Ma and Weimin Mao and Yousheng Mao and Juwei Mou and Calvin Sze Hang Ng and René H. Petersen and Guibin Qiao and Gaetano Rocco and Erico Ruffini and Lijie Tan and Qunyou Tan and Tang Tong and Haidong Wang and Qun Wang and Ruwen Wang and Shumin Wang and Deyao Xie and Qi Xue and Tao Xue and Lin Xu and Shidong Xu and Songtao Xu and Tiansheng Yan and Fenglei Yu and Zhentao Yu and Chunfang Zhang and Lanjun Zhang and Tao Zhang and Xun Zhang and Xiaojing Zhao and Xuewei Zhao and Xiuyi Zhi and Qinghua Zhou},
title = {The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy},
journal = {Journal of Thoracic Disease},
volume = {9},
number = {9},
year = {2017},
keywords = {},
abstract = {Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes. In order to understand the available evidence, a systematic review was conducted including the following topics: (I) protective ventilation (PV); (II) mode of mechanical ventilation [e.g., volume controlled (VCV) versus pressure controlled (PCV)]; (III) use of therapeutic hypercapnia; (IV) use of alveolar recruitment (open-lung) strategy; (V) pre-and post-operative application of positive end expiratory pressure (PEEP); (VI) Inspired Oxygen concentration; (VII) Non-intubated thoracoscopic lobectomy; and (VIII) adjuvant pharmacologic options. The recommendations of class II are non-intubated thoracoscopic lobectomy may be an alternative to conventional one-lung ventilation in selected patients. The recommendations of class IIa are: (I) Therapeutic hypercapnia to maintain a partial pressure of carbon dioxide at 50–70 mmHg is reasonable for patients undergoing pulmonary lobectomy with one-lung ventilation; (II) PV with a tidal volume of 6 mL/kg and PEEP of 5 cmH2O are reasonable methods, based on current evidence; (III) alveolar recruitment [open lung ventilation (OLV)] may be beneficial in patients undergoing lobectomy with one-lung ventilation; (IV) PCV is recommended over VCV for patients undergoing lung resection; (V) pre- and post-operative CPAP can improve short-term oxygenation in patients undergoing lobectomy with one-lung ventilation; (VI) controlled mechanical ventilation with I:E ratio of 1:1 is reasonable in patients undergoing one-lung ventilation; (VII) use of lowest inspired oxygen concentration to maintain satisfactory arterial oxygen saturation is reasonable based on physiologic principles; (VIII) Adjuvant drugs such as nebulized budesonide, intravenous sivelestat and ulinastatin are reasonable and can be used to attenuate inflammatory response.},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/15690}
}