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Practical Handbook of Thoracic Anesthesia pp 71–92Cite as

Physiology of One-Lung Ventilation

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Abstract

Published estimates of the incidence of hypoxemia during ­one-lung ventilation (OLV) have decreased from 25% in the 1970s to currently less than 10% (1 2). Technical improvements (fiberoptic bronchoscopy, DLT design, etc.) account for some of this progress (Chapter 8). Improved understanding of the physiology of OLV has also contributed importantly and is the topic of this chapter.

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Selected References

  1. Karzai W, Schwarzkopf K. Hypoxemia during one-lung ventilation. Anesthesiology. 2009;110:1402–11.

    Article  PubMed  Google Scholar 

  2. Brodsky JB, Lemmens HJ. Left double-lumen tubes:clinical experience with 1170 patients. J Cardiothorac Vasc Anesth. 2003;17:289–98.

    Article  PubMed  Google Scholar 

  3. Kozian A, Schilling T, Schutze H, Hachenberg T, Hedenstierna G. Lung ­computed tomography density distribution in a porcine model of one-lung ventilation. Br J Anaesth. 2009;102(4):551–60.

    Article  PubMed  CAS  Google Scholar 

  4. Lohser J. Evidence-based management of one-lung ventilation. Anesthesiol Clin. 2008;26:241–72.

    Article  PubMed  Google Scholar 

  5. Hurford W, Kolker AC, Strauss HW. The use of ventilation/perfusion lung scans to predict oxygenation during one-lung anesthesia. Anesthesiology. 1987;67:841–44.

    Article  PubMed  CAS  Google Scholar 

  6. Slinger P, Suissa S, Triolet W. Predicting arterial desaturation during one-lung anaesthesia. Can J Anaesth. 1992;39:1030–5.

    Article  PubMed  CAS  Google Scholar 

  7. Slinger P, Kruger M, McRae K, et al. Relation of the static compliance curve and positive end-expiratory pressure to oxygenation during one-lung ventilation. Anesthesiology. 2001;95(5):1098–2006.

    Article  Google Scholar 

  8. Nakatsuka M, Wetstein L, Keenan RL. Unilateral high-frequency jet ventilation during one-lung ventilation for thoracotomy. Ann Thorac Surg. 1995;59(6):1610–4.

    Article  PubMed  CAS  Google Scholar 

  9. Ko R, McRae K, Darling G, et al. The use of air in the inspired gas mixture during two-lung ventilation delays lung collapse during one-lung ventilation. Anesth Analg. 2009;108(4):10926.

    Article  Google Scholar 

  10. Ducros L, Moutafis M, Castelain M, et al. Pulmonary air trapping during two-lung and one-lung ventilation. J Cardiothorac Vasc Anesth. 1999;13(1):35–9.

    Article  PubMed  CAS  Google Scholar 

  11. Gay G, Rodarte J, Hubmayer R, et al. The effects of positive end-expiratory pressure on isovolemic flow and dynamic hyperinflation in patients receiving mechanical ventilation. Am Rev Resp Dis. 1989;139:621–6.

    PubMed  CAS  Google Scholar 

  12. Tugrul M, Camci E, Karadeniz H, et al. Comparison of volume controlled with pressure controlled ventilation during one-lung anesthesia. Br J Anaesth. 1997;79:306–10.

    PubMed  CAS  Google Scholar 

  13. Unzueta MC, Casa JI, Moral MV. Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for thoracic surgery. Anesth Analg. 2007;104:1029–33.

    Article  PubMed  Google Scholar 

  14. Tusman G, Bohm SH, Sipman FS, Maisch S. Lung recruitment improves the efficiency of ventilation and gas exchange during one-lung anesthesia. Anesth Analg. 2004;98(6):1604–9.

    Article  PubMed  Google Scholar 

  15. Cinnella G, Grasso S, Natale C, et al. Physiologic effects of a lung-recruiting strategy applied during one-lung ventilation. Acta Anasthesiol Scand. 2008;52(6):766–75.

    Article  CAS  Google Scholar 

  16. Bardoczky G, Szegedi L, d’Hollander A, et al. Two-lung and one-lung ventilation in patients with chronic obstructive pulmonary disease: the effects of position and FiO2. Anesth Analg 2000;90(1):35–41.

    Google Scholar 

  17. Dennehy KC, Dupuis JY, Nathan HJ, Wynands JE. Profound hypoxemia during treatment of low cardiac output after cardiopulmonarty bypass. Can J Anaesth. 1999;46:56–60.

    Article  PubMed  CAS  Google Scholar 

  18. Casthely PA, Lear F, Cottrell JE, Lear E. Intrapulmonary shunting during induced hypotension. Anesth Analg. 1982;61:231–5.

    Article  PubMed  CAS  Google Scholar 

  19. Hartigan P, Formanek V, Shernan S, et al. Inhaled nitric oxide fails to improve gas exchange during one-lung ventilation. Anesthesiology. 1996;A1165.

    Google Scholar 

  20. Sticher J, Scholz S, Boning O, et al. Small dose nitric oxide improves oxygenation during one-lung ventilation: An experimental study. Anesth Analg. 2002;95:1557–62.

    Article  PubMed  CAS  Google Scholar 

  21. Moutafis M, Dalibon N, Liu N, et al. The effects of intravenous almitrine on oxygenation and hemodynamics during one-lung ventilation. Anesth Analg. 2002;94:830–4.

    Article  PubMed  CAS  Google Scholar 

  22. Schwarzkopf K, Schreiber T, Bauer R, et al. The effects of increasing doses of isoflurane and desflurane on pulmonary perfusion and systemic oxygenation during one-lung ventilation in pigs. Anesth Analg. 2001;93:1434–38.

    Article  PubMed  CAS  Google Scholar 

  23. Slinger P, Scott W. Arterial oxygenation during one-lung ventilation. A comparison of isoflurane and enflurane Anesthesiology. 1995;82(4):940–46.

    CAS  Google Scholar 

  24. Wang J, Russell G, Page R, et al. Comparison of the effects of desflurane and isoflurane on arterial oxygenation during one-lung ventilation. Br J Anaesth. 1998;81(6):850–3.

    PubMed  CAS  Google Scholar 

  25. Wang J, Russell G, Page R, et al. A comparison of the effects of desflurane and isoflurane on arterial oxygenation during one-lung ventilation. Anaesthesia. 2000;55(2):167–73.

    Article  PubMed  CAS  Google Scholar 

  26. Abe K, Shimizu T, Takashina M, et al. The effects of propofol, isoflurane, and sevoflurane on oxygenation and shunt fraction during one-lung ventilation. Anesth Analg. 1998;87:1164–9.

    PubMed  CAS  Google Scholar 

  27. Schwarzkopf K, Schreiber T, Preussler N-P, et al. Lung perfusion, shunt fraction, and oxygenation during one-lung ventilation in pigs: the effects of desflurane, isoflurane, and propofol. J Cardiothorac Vasc Anesth. 2003;17(1):73–5.

    Article  PubMed  Google Scholar 

  28. Szegedi LL, Van der Linden P, Ducart A, et al. The effects of acute hypovolemic hemodilution on oxygenation during one-lung ventilation. Anesth Analg. 2005;100:15–20.

    Article  PubMed  Google Scholar 

  29. Levin AI, Coetzee JF. Arterial oxygenation during one-lung anesthesia. Anesth Analg. 2005;100(1):12–4.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Thoracic Anaesthesia Department of Anaesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Philip M. Hartigan MD (Assistant Professor of Anaesthesia, Harvard Medical School Director)

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  1. Philip M. Hartigan MD
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Editors and Affiliations

  1. Perioperative and Pain Medicine,, Harvard Medical School, Assistant Prof, Dept of Anesthesiology,, Brigham and Women's Hospital, Boston, 02115, Massachusetts, USA

    Philip M. Hartigan

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© 2012 Springer Science+Business Media, LLC

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Hartigan, P.M. (2012). Physiology of One-Lung Ventilation. In: Hartigan, P. (eds) Practical Handbook of Thoracic Anesthesia. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-88493-6_5

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  • DOI: https://doi.org/10.1007/978-0-387-88493-6_5

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-88492-9

  • Online ISBN: 978-0-387-88493-6

  • eBook Packages: MedicineMedicine (R0)

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