The Journal of Thoracic and Cardiovascular Surgery, Vol 88, 22-25, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Transcutaneous monitoring of oxygen tension during one-lung anesthesia
KK Tremper, HN Konchigeri, BF Cullen, PA Kapur, D Thangathurai and C Percival
Twenty adult patients were monitored with a transcutaneous oxygen tension
sensor during one-lung ventilation. Anesthesia was maintained with
enflurane-oxygen or isoflurane-oxygen. The transcutaneous oxygen tension
values accurately followed the trend of arterial oxygen tension (r = 0.94,
n = 96, transcutaneous oxygen tension = 4.8 + 0.78 X arterial oxygen
tension). The transcutaneous oxygen tension values averaged 80% of the
arterial oxygen tension values (transcutaneous oxygen tension index =
transcutaneous oxygen tension/arterial oxygen tension = 0.80 +/- 0.18)
(mean +/- standard deviation). When one-lung ventilation was initiated,
there was a progressive drop in transcutaneous oxygen tension which reached
a minimum of 19 +/- 10 minutes. The mean of the minimum transcutaneous
oxygen tension and arterial oxygen tension values was 66 +/- 44 torr and 83
+/- 43 respectively. This resulted in a mean alveolar-arterial oxygen
gradient of 515 +/- 152 torr during one-lung ventilation. In eight
patients, the arterial oxygen tension fell below 60 torr, 45 +/- 9 torr.
When two- lung ventilation was resumed, the transcutaneous oxygen tension
and arterial oxygen tension values promptly rose to mean values of 342 +/-
121 torr and 411 +/- 103 torr, respectively in 9 +/- 3 minutes. The
transcutaneous oxygen tension monitor provided a continuous assessment of
the patient's oxygenation, gave early warning of potentially hazardous
hypoxia, and permitted nearly real-time assessment of the efficacy of
corrective therapies.
