Intraoperative hypoxemia during one-lung ventilation: Is it still an anesthesiologists' nightmare? (hypoxemia during one-lung ventilation)

Abstract

Lung isolation is used for various surgical and non-surgi-cal reasons. This type of ventilation carries the risk for va-rious degrees of ventilation/perfusion mismatch associa-ted with lateral decubitus position, one-lung ventilation (OLV) and opened chest. According to this, hypoxemia is common consequence of OLV. Among various recom-mended ventilation strategies in order to prevent hypo-xemia, protective ventilation with lower tidal volumes and applied positive end-expiratory (PEEP) pressure give some promising results. Adequate treatment and possibi-lity to predict hypoxemia during OLV is very important for reducing morbidity and mortality. Treatment inclu-des ventilator strategies on both, ventilated and non-ven-tilated lung and applied therapy, which can influence and modulate the magnitude of phenomenon unique for lung circulation -hypoxic pulmonary vasoconstriction (HPV).

Keywords

• hypoxemia
• one lung ventilation
• hypoxic pulmonary vasoconstriction