Predictive Value Of The Initial End-Tidal Carbon Dioxide Difference For The Occurrence Of Hypoxemia During One-Lung Anesthesia

Objective:One-lung ventilation(OLV)was a special kind of ventilation during thoracic surgery,which has the characteristics of fully exposing the surgical field of vision,reducing the injury of surgical operation and speeding up the process of operation.But with this technique,significant arterial hypoxemia is observed in 10%of patients.The purpose of this study was to examine the correlation between the arterial hypoxemia and the end-tidal CO2(ETC O2)difference between two-lung ventilation(TLV)and the early phase of one-lung ventilation(OLV),and to test the predictive value of the difference for arterial hypoxemia with the receiver operating characteristic curve.Methods:This was a retrospective cohort study and carried out in kunming Medical University First Hospital from June 1.2019 to October 30.2019.The main observation endpoint was the incidence of hypoxemia during One-lung ventilation in patients.the main observation endpoint was the incidence of hypoxemia during OLV in patients.By means of logical regression analysis,the correlation between the difference of the end-tidal CO2 of One-lung and the occurrence of OLV was analyzed,The ROC Curve was used to analyze the value of the end-tidal CO2(ETCO2)difference between two-lung ventilation(TLV)and the early phase of one-lung ventilation(OLV)in predicting arterial hypoxemia during OLV.When the cut-off value of ?PETCO2?5,the sensitivity was 0.636,and the specificity was 0.849.Results:In the study.309 patient were included in the final analysis.The overall arterial hypoxemia during OLV was 14.2%.Multivariate Logistic regression showed three factors associated with arterial hypoxemia including PaO2(OR=0.811,95%CI:0.754?0.873,P<0.05)?BMI(OR=1.386,95%CI:1.190?1.641??PETCO2(OR=2.942?95%CI:1.981?4.370).The areas under the ROC curve of ?PETCO2:0.772(95%CI:0.615?0.929,P=0.004).ConcluSion:The end-tidal C02(ETCO2)difference between two-lung ventilation(TLV)and the early phase of one-lung ventilation(OLV)was related with increased incidence of arterial hypoxemia,and ROC curve analysis showed predictive value.