Severe hypoxemia follows hypoxic pulmonary vasoconstriction and/or hypoxic pulmonary vasoconstriction inhibition by inhaled anesthetics: prognostic potential of 100% shunt fractions

摘要

Hypoxic Pulmonary Vasoconstriction (HPV) was first reported by Bindsley et al. in adult patients and was managed using double lumen catheters to ventilate one lung with 100% oxygen and the other with 95% N 2 and 5% oxygen during intravenous barbiturate and fentanyl anesthesia. 1 However, ''HPV inhibition'' has predominantly been attributed to the use of inhalation agents and is considered as a cause of hypoxia during anesthesia. Moreover, both in vitro and in vivo studies have demonstrated that inhalation agents inhibit HPV under a range of conditions, 2---5 and sevoflu- rane has been shown to decrease HPV in a dose-dependent manner. 4,6,7.