Higher dead space ventilation (V D/V T) may be a surrogate for right ventricular to pulmonary artery uncoupling (RV-PA) during cardiopulmonary exercise testing (CPET) to explain persistent exercise limitations. We conclude that pressure-controlled ventilation may be useful to improve gas exchange and alveolar recruitment during one lung ventilation.(1) Background: The exercise capacity of patients with a left ventricular assist device (LVAD) remains limited despite mechanical support. After one-lung ventilation patients with pressure controlled ventilation had lower alveolar-arterial oxygen tension difference and a higher arterial oxygen partial pressure with significant differences for those patients in the intensive care unit. We observed, that peak airway pressure, dead space ventilation and arterial carbon dioxide partial pressure were significantly higher during volume-controlled ventilation. Parameters of ventilation, pulmonary function and systemic and pulmonary hemodynamics were recorded. In the other group, volume-controlled ventilation was continued. In one group, ventilation was switched to pressure-controlled ventilation after starting one-lung ventilation. After two-lung ventilation with volume-controlled ventilation, patients were divided randomly into two groups. We studied 50 patients undergoing thoracotomy and one-lung ventilation because of cardiovascular disease. Previous clinical studies compared pressure-controlled versus volume-controlled ventilation during one-lung ventilation in patients with pre-existing pulmonary disease. One-lung ventilation is limited by hypoventilation and hypoxemia because of increasing airway pressure and intrapulmonary shunt.
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