Effect of Iloprost on Pulmonary Oxygenation in Patients With Low Diffusing Capacity During One-lung Ventilation

One lung ventilation (OLV) is essential during thoracic surgery. During OLV, intrapulmonary shunt can be increased resulting hypoxemia. Although OLV technique had been advanced so far, hypoxemia during OLV reaches about 10% in spite of inspired oxygen fraction 100%. Iloprost is a prostaglandin analogue used for pulmonary hypertension, which can decrease pulmonary artery resistance by selectively dilating pulmonary artery. In this prospective, randomized, double blind study, investigators are planning to investigate the effects of iloprost on respiratory physiology (intrapulmonary shunt, deadspace, oxygenation, etc).

Inclusion Criteria:

• scheduled for Video-assisted thoracoscopic surgery (VATS) lobectomy
• 40 < age < 80
• American Society of Anaesthesiologists (ASA) physical status classification I~III
• diffusing capacity (DLCO) <75% at pre op. pulmonary function test

Exclusion Criteria:

• American Society of Anaesthesiologists (ASA) physical status classification IV
• New York Heart Association (NYHA) class III~IV
• Severe obstructive lung disease and/or restrictive lung disease patients
• patients with end-organ diseases (i.e. heart failure, respiratory failure, hepatic failure, renal failure)
• arrhythmia
• pregnant women
• disease that can influence the DLCO result (anemia, pulmonary vascular disease)