Cardiothoracic & vascular anesthesia
Impact of Lower Tidal Volumes During One-Lung Ventilation: A 2022 Update of the Meta-analysis of Randomized Controlled Trials
Pooled result · PaO2/FIO2 ratioResult — go to the resultMean difference 18.59 mmHgAuthors' conclusion
The use of lower tidal volume, a component of protective OLV, increases the PaO2/FIO2 ratio, reduces the incidence of postoperative pulmonary complications
Study context
- Population
- Patients receiving one-lung ventilation (OLV) for thoracic surgery
- Participants
- 1,463 patients · 17 RCTs
- Comparison
- Lower vs higher tidal volume during OLV
- Outcome
- PaO2/FIO2 ratio after reinstitution of two-lung ventilation
- Follow-up
- End of surgery
Pooled result
PaO2/FIO2 ratio
Mean difference
18.59 mmHg
P < 0.001
As reported in the abstract
Further pooled results
| Outcome | Estimate | P value |
|---|---|---|
| PaO2/FIO2 ratio · 15 minutes after start of OLV | mean difference 33.7 mmHg | P = 0.02 |
| PPCs | OR 0.50 | P < 0.001 |
PaCO2 and airway pressure
- Higher PaCO2 at 15 and 60 minutes after start of OLV and lower airway pressure, maintained during two-lung ventilation after surgery, with lower tidal volume
Hospital LOS
- No difference in length of hospital stay
Safety
| Outcome | OR | P value |
|---|---|---|
| Arrhythmias | 0.58 | P = 0.009 |
Original publication
Impact of Lower Tidal Volumes During One-Lung Ventilation: A 2022 Update of the Meta-analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth. Published 20 April 2023. doi:10.
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