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Smoking as a risk factor for intraoperative hypoxemia during one lung ventilation

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Abstract

Background

Smoking is associated with many intra and postoperative events, especially respiratory complications. Hypoxemia and airway damage are found to aggravate any pre-existing respiratory pathology among smokers. One lung ventilation (OLV) carries a 4–10 % risk of development of hypoxia.

Aim

The purpose of this study was to predict the incidence of hypoxemia for smokers during OLV for patients undergoing video-assisted thoracoscopic surgery (VATS).

Patients and methods

Sixty patients undergoing VATS using OLV by double lumen tube were included in this pilot cross-sectional study. These patients were divided into 2 groups, group S which included 30 heavy smoker patients (smoking more than 20 cigarettes per day for more than 20 years) and group NS which included 30 non-smoker patients. Intra and postoperative arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2), and intraoperative peak airway pressure were compared between the 2 groups.

Results

PaO2 was significantly higher in the non-smoker group than in the smoker group, both at the start and end of OLV. It was 173 ± 68 mmHg for NS compared with 74 ± 10.8 mmHg for S at the start of OLV; at the end of OLV it was 410 ± 78 mmHg for the former and 360 ± 72 mmHg for the latter (P < 0.05).

Conclusion

From this study it can be concluded that for heavy smoker patients there was a significant reduction in arterial oxygen tension (PaO2) in comparison with non-smokers. However, hypoxemia reported for both groups was comparable.

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Authors and Affiliations

  1. Department of Anesthesia, Faculty of Medicine, Cairo University, Giza, Egypt

    Mohamed A. Khalil

  2. Saad Specialist Hospital, Prince Faisal Bin Fahad Street, Al-Khobar, 31952, Saudi Arabia

    Mohamed A. Khalil

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  1. Mohamed A. Khalil
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Correspondence to Mohamed A. Khalil.

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Khalil, M.A. Smoking as a risk factor for intraoperative hypoxemia during one lung ventilation. J Anesth 27, 550–556 (2013). https://doi.org/10.1007/s00540-013-1559-y

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  • DOI: https://doi.org/10.1007/s00540-013-1559-y

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