| Title | The Society for Translational Medicine: clinical practice guidelines for mechanical ventilation management for patients undergoing lobectomy |
| Authors | Gao, Shugeng Zhang, Zhongheng Brunelli, Alessandro Chen, Chang Chen, Chun Chen, Gang Chen, Haiquan Chen, Jin-Shing Cassivi, Stephen Chai, Ying Downs, John B. Fang, Wentao Fu, Xiangning Garutti, Martinez I. He, Jianxing He, Jie Hu, Jian Huang, Yunchao Jiang, Gening Jiang, Hongjing Jiang, Zhongmin Li, Danqing Li, Gaofeng Li, Hui Li, Qiang Li, Xiaofei Li, Yin Li, Zhijun Liu, Chia-Chuan Liu, Deruo Liu, Lunxu Liu, Yongyi Ma, Haitao Mao, Weimin Mao, Yousheng Mou, Juwei Ng, Calvin Sze Hang Petersen, Rene H. Qiao, |
| Affiliation | Chinese Acad Med Sci, Canc Inst & Hosp, Dept Thorac Surg Oncol, Beijing 100021, Peoples R China. Peking Union Med Coll, Natl Canc Ctr, Beijing 100021, Peoples R China. Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Emergency Med, Hangzhou 310016, Zhejiang, Peoples R China. St James Univ Hosp, Dept Thorac Surg, Leeds, W Yorkshire, England. Shanghai Pulm Hosp, Dept Thorac Surg, Shanghai 200433, Peoples R China. Fujian Med Univ, Union Hosp, Dept Thorac Surg, Fujian 350001, Peoples R China. Guangdong Gen Hosp, Dept Thorac Surg, Guangzhou 510080, Guangdong, Peoples R China. Shanghai Chest Hosp, Shanghai 200030, Peoples R China. Natl Taiwan Univ Hosp, Dept Anesthesiol, Taipei 10002, Taiwan. Natl Taiwan Univ, Coll Med, Taipei 10002, Taiwan. Mayo Clin, Phoenix, AZ USA. Zhejiang Univ, Med Coll, Affiliated Hosp 2, Hangzhou 310009, Zhejiang, Peoples R China. Univ Florida, Dept Anesthesiol & Crit Care Med, Gainesville, FL USA. Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Thorac Surg, Wuhan 430030, Hubei, Peoples R China. Hosp Gen Univ Gregorio Maranon, Dept Anaesthesia & Postoperat Care, Madrid, Spain. Guangzhou Med Univ, Affiliated Hosp 1, Dept Thorac Surg, Guangzhou 510000, Guangdong, Peoples R China. Guangzhou Inst Resp Dis, Guangzhou 510000, Guangdong, Peoples R China. China State Key Lab Resp Dis, Guangzhou 510000, Guangdong, Peoples R China. Natl Clin Res Ctr Resp Dis, Guangzhou 510000, Guangdong, Peoples R China. Zhejiang Univ, Med Coll, Affiliated Hosp 1, Hangzhou 310003, Zhejiang, Peoples R China. Yunnan Canc Hosp, Dept Thorac Surg, Kunming 650100, Yunnan, Peoples R China. Tianjin Med Univ, Canc Inst & Hosp, Dept Esophageal Oncol, Tianjin 300060, Peoples R China. Shandong Qianfoshan Hosp, Dept Thorac Surg, Jinan 250014, Shandong, Peoples R China. Beijing Union Med Coll Hosp, Dept Thorac Surg, Beijing 100032, Peoples R China. Beijing Chaoyang Hosp, Dept Thorac Surg, Beijing 100049, Peoples R China. Sichuan Canc Hosp & Inst, Dept Thorac Surg, Chengdu 610041, Sichuan, Peoples R China. Fourth Mil Med Univ, Tangdu Hosp, Dept Thorac Surg, Xian 710038, Shaanxi, Peoples R China. Henan Canc Hosp, Dept Thorac Surg, Zhengzhou 450008, Henan, Peoples R China. Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Thorac Surg, Hangzhou 310016, Zhejiang, Peoples R China. Sun Yat Sen Canc Ctr, Dept Surg, Div Thorac Surg, Taipei, Taiwan. China & Japan Friendship Hosp, Dept Thorac Surg, Beijing 100029, Peoples R China. Sichuan Univ, West China Hosp, Dept Cardiovasc & Thorac Surg, Chengdu 610041, Sichuan, Peoples R China. Liaoning Canc Hosp & Inst, Dept Thorac Surg, Shenyang 110042, Peoples R China. Soochow Univ, Hosp Affiliated 1, Dept Thorac Surg, Suzhou 215000, Peoples R China. Zhejiang Canc Hosp, Dept Thorac Surg, Hangzhou 310000, Zhejiang, Peoples R China. Chinese Univ Hong Kong, Prince Wales Hosp, Dept Surg, Shatin, Hong Kong, Peoples R China. Rigshosp, Dept Cardiothorac Surg, Copenhagen, Denmark. Guangzhou Gen Hosp, Guangzhou Mil Area Command, Dept Thorac Surg, Guangzhou 510000, Guangdong, Peoples R China. Pascale Fdn, Natl Canc Inst, Dept Thorac Surg & Oncol, Naples, Italy. Univ Turin, Thorac Surg Unit, Turin, Italy. Fudan Univ, Shanghai Zhongshan Hosp, Dept Thorac Surg, Shanghai 200032, Peoples R China. Third Mil Med Univ, Res Inst Surg, Daping Hosp, Dept Thorac Surg, Chongqing 400042, Peoples R China. Jilin Univ, Affiliated Hosp 2, Dept Thorac Surg, Changchun 130041, Jilin, Peoples R China. Third Millitary Med Univ, Southwest Hosp, Dept Thorac Surg, Chongqing 400038, Peoples R China. Gen Hosp Shenyang Mil Area, Shenyang Mil Area, Dept Thorac Surg, Shenyang 110015, Liaoning, Peoples R China. Wenzhou Med Univ, Affiliated Hosp 1, Dept Cardiovasc & Thorac Surg, Wenzhou 325000, Peoples R China. Southeast Univ, Zhongda Hosp, Dept Thorac Surg, Nanjing 210009, Jiangsu, Peoples R China. Jiangsu Canc Hosp, Dept Thorac Surg, Nanjing 210008, Jiangsu, Peoples R China. Heilongjiang Canc Hosp, Dept Thorac Surg, Harbin 150049, Heilongjiang, Peoples R China. Peking Univ, Hosp 3, Dept Thorac Surg, Beijing 100083, Peoples R China. South Univ, Xiangya Hosp Cent 2, Dept Cardiovasc Surg, Changsha 410011, Hunan, Peoples R China. Cent S Univ, Xiangya Hosp, Dept Thorac Surg, Changsha 410008, Hunan, Peoples R China. San Yat Sen Univ, Canc Ctr, Guangzhou 510060, Guangdong, Peoples R China. Xinjiang Med Univ, Affiliated Hosp 1, Dept Thorac Surg, Urumqi 830011, Peoples R China. Tanjin Chest Hosp, Dept Thorac Surg, Tianjin 300300, Peoples R China. Shanghai Jiao Tong Univ, Sch Med, Renji Hosp, Dept Thorac Surg, Shanghai 200000, Peoples R China. Shanghai Changzheng Hosp, Dept Thorac Surg, Shanghai 200000, Peoples R China. Capital Univ Med Sci, Xuanwu Hosp, Dept Thorac Surg, Beijing 100053, Peoples R China. Chinese Acad Med Sci, Canc Inst & Hosp, Dept Thorac Surg Oncol, Beijing 100021, Peoples R China. Gao, SG He, J (reprint author), Peking Union Med Coll, Natl Canc Ctr, Beijing 100021, Peoples R China. |
| Keywords | Mechanical ventilation lobectomy guideline tidal volume ONE-LUNG VENTILATION NONINTUBATED THORACOSCOPIC LOBECTOMY RESPIRATORY-DISTRESS-SYNDROME VOLUME-CONTROLLED VENTILATION ISCHEMIA-REPERFUSION INJURY END-EXPIRATORY PRESSURE THORACIC-SURGERY PULMONARY-FUNCTION TIDAL-VOLUME THERAPEUTIC HYPERCAPNIA |
| Issue Date | 2017 |
| Publisher | JOURNAL OF THORACIC DISEASE |
| Citation | JOURNAL OF THORACIC DISEASE. 2017, 9(9), 3246-3254. |
| 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 cmH(2)O 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. |
| URI | http://hdl.handle.net/20.500.11897/501101 |
| ISSN | 2072-1439 |
| DOI | 10.21037/jtd.2017.08.166 |
| Indexed | SCI(E) PubMed |
| Appears in Collections: | 第三医院 |
