Independent lung ventilation using a piston-driven anesthesia machine to ventilate the affected lung during resection of the visceral pleura for malignant pleural mesothelioma: A case series

Our plain-English summary of Independent lung ventilation using a piston-driven anesthesia machine to ventilate the affected lung during resection of the visceral pleura for malignant pleural mesothelioma: A case series, by T. Kida, T. Kobashi, T. Takei, et al (Journal of Clinical Anesthesia, 2021).

The study

• Authors: T. Kida, T. Kobashi, T. Takei, T. Morohoshi, M. Sumitomo
• Journal: Journal of Clinical Anesthesia
• Published: 2021;75:110456
• Type of article: Letter
• Read it: PubMed · Publisher

In plain English

This article is a letter to the editor describing a single-center case series from Yokosuka Kyosai Hospital in Japan. It concerned anesthesia during pleurectomy/decortication, an operation for malignant pleural mesothelioma. It did not study asbestos exposure. From January 2017 to May 2020, 11 patients had this surgery with independent lung ventilation, in which each lung is ventilated separately. While surgeons removed the visceral pleura (the lining on the lung itself), a second piston-driven anesthesia machine ventilated the affected lung with room air. Air leaked from the lung in 10 patients. In eight of those 10, the lung stayed adequately inflated without changing the initial machine settings. In the other 2, massive leakage left inflation visually inadequate, and the inspiratory flow was raised from 30 to 60–70 L/min. The authors reported no evidence of severe hypoxemia (low blood oxygen), and all patients had their breathing tube removed in the operating room. The authors concluded that the technique was feasible and safe without major complications, and they recommended it for patients with malignant pleural mesothelioma undergoing this surgery.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective single-center case series, published as a letter to the editor (correspondence)
• Who was studied: 11 patients with malignant pleural mesothelioma who underwent pleurectomy/decortication under general anesthesia with independent lung ventilation at Yokosuka Kyosai Hospital, Japan, January 2017 to May 2020
• Exposure: Not reported. The study concerned an anesthesia ventilation technique, not asbestos or fiber exposure.
• Main results:
  • Pulmonary air leakage occurred during visceral pleura resection in 10 of the 11 patients
  • In 8 of the 10 patients with air leakage, the affected lung was adequately inflated without changing the initial ventilator settings
  • In the other 2 patients, massive air leakage left inflation visually inadequate; these cases were managed by raising the inspiratory flow from 30 to 60–70 L/min
  • Although the affected lung was ventilated with room air, there was no evidence of severe hypoxemia
  • All 11 patients were successfully extubated in the operating room
• The authors' conclusion: The authors concluded that independent lung ventilation using a piston-driven anesthesia machine to ventilate the affected lung during visceral pleura resection was feasible and safe without major complications, and they recommended the technique for patients with malignant pleural mesothelioma undergoing pleurectomy/decortication.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Visceral Pleura, Pleural Mesothelioma.

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