One-lung ventilation (OLV) is a recognized and modifiable risk factor for acute lung injury. OLV needs to be individualized to the patient’s predicted body weight and their particular lung mechanics. Protective OLV is a combination of small, physiologic tidal volumes with consequently low ventilating pressures and routine, individualized PEEP to facilitate open lung ventilation. Ventilator-induced lung injury is preventable by minimizing driving pressure, which is a direct correlate of transpulmonary stress and strain. In patients at particular risk of lung injury, the use of permissive hypercapnia may facilitate a decrease in the mechanical strain onto the lung. Hypoxemia during one-lung ventilation is now rare and often secondary to alveolar de-recruitment in the face of hypoventilation. Management of hypoxemia requires a structured treatment algorithm.
CITATION STYLE
Schisler, T., & Lohser, J. (2019). Clinical Management of One-Lung Ventilation. In Principles and Practice of Anesthesia for Thoracic Surgery: Second Edition (pp. 107–129). Springer International Publishing. https://doi.org/10.1007/978-3-030-00859-8_6
Mendeley helps you to discover research relevant for your work.