Abstract
In a case of arterial hypotension during one-lung ventilation, haemodynamic support may be required to maintain adequate mean arterial pressure. Arginine vasopressin, a potent systemic vasoconstrictor with limited effects on the pulmonary artery pressure, has not been studied in this setting. Twelve female pigs were anaesthetised and ventilated and arterial, central venous and pulmonary artery catheters were inserted. A left-sided double lumen tube was placed via tracheostomy and one-lung ventilation was initiated. The animals were in the left lateral position, with the left lung ventilated and right lung collapsed. Respiratory and haemodynamic values were recorded before and during a continuous infusion of arginine vasopressin sufficient to double the mean arterial pressure. The arginine vasopressin caused a decrease in cardiac output (3.8±1.1 vs. 2.7±0.7 l/min, P <0.001) and mixed-venous oxygen tension (39.1±5.8 vs. 34.4±5 mmHg, P=0.003). Pulmonary artery pressure was unchanged (24±2 vs. 24±3 mmHg, P=0.682). There was no effect of the arginine vasopressin on arterial oxygen tension (226±106 vs. 231±118 mmHg, P=0.745). However, there was a significant decrease in shunt fraction (28.3±6.2 vs. 24.3±7.8%, P=0.043) and a significant proportional increase in perfusion of the ventilated lung (78.8±9.5 vs. 85.5±7.9%, P=0.036). In our animal model of one-lung ventilation, doubling mean arterial pressure by infusion of arginine vasopressin significantly affected global haemodynamics, but had no influence on systemic arterial oxygen tension.