Management of Hypoxia During One Lung Ventilation
Thoracic operations are usually performed with the patient in the lateral position with selective one-lung ventilation (OLV) to the dependent lung. Even after the non-dependent, operated lung is intentionally collapsed it continues to be perfused with blood. Even under the best of circumstances this wasted perfusion, or “shunt”, remains 20–25% of cardiac output. Even so, the majority of patients undergoing thoracic operations are able to maintain adequate arterial oxygen tension (PaO2) during OLV. The extent of shunt is determined by many factors . If hypoxia does occur during OLV then efforts are directed toward optimizing the matching of ventilation with perfusion (V/Q) in the dependent ventilated lung and/or increasing the oxygen content of the shunted blood returning from the collapsed lung.
KeywordsChronic Obstructive Pulmonary Disease Continuous Positive Airway Pressure Acute Lung Injury Pulmonary Vascular Resistance Functional Residual Capacity
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