Arterial oxygenation during one‐lung anaesthesia (1)

Arterial oxygenation and one-lung anesthesia

“…Increasing alveolar ventilation using larger tidal volumes is theoretically attractive as it may also prevent small airway closure and the development of low ventilation perfusion units that result from the decrease in dependent lung volume during OLA [1]. The use of larger (15 ml/kg) [55] and smaller tidal volumes [56,57] during OLA have been linked with increases and decreases, respectively, in arterial oxygenation; however, utilizing larger tidal volumes has not universally resulted in statistically significant [4, [58][59][60] or clinically important [21,55] increases in arterial oxygenation. The reasons for this conflicting evidence include firstly that increases in lung volume lead to increases in pulmonary vascular resistance and diversion of blood flow toward the nonventilated lung [4, 21,25,[58][59][60].…”

Effect of Positive End‐Expiratory Pressure on Oxygen Delivery During 1‐Lung Ventilation for Thoracoscopy in Normal Dogs

“…[16][17][18][19][20][21][22] During thoracoscopy, the intrathoracic negative pressure is removed and dogs are commonly placed in lateral recumbency, which worsens atelectasis of the dependent lung and hypoxemia. 19,20,[23][24][25][26][27] Thus, patients undergoing open-chest 1-lung ventilation during thoracoscopy are at high risk for hypoxemia because of a high shunt fraction.…”

Facilitation of alternative one-lung and two-lung ventilation by use of an endotracheal tube exchanger for pediatric empyema during video-assisted thoracoscopy

“…Recruiting atelectatic zones of the dependent lung and applying sufficient levels of PEEP may attenuate the decrease in PaO 2 during one-lung ventilation. Continued perfusion of the nonventilated lung results in a gross shunt effect associated with hypoxemia [10], and the hypoxemia may be decreased by active hypoxic pulmonary vasoconstriction, which results in a gradual redistribution of pulmonary blood flow away from the hypoxic collapsed lung into the ventilated lung [11]. In our study, we used a high concentration of inspired oxygen (FIO 2 , 1.0) and intermittent two-lung ventilations.…”