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Evidence-based management of one-lung ventilation
1Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver Acute, Vancouver General Hospital, Vancouver, British Columbia V5Z 1M9, Canada. jens.lohser@vch.ca
Anesthesiology Clinics
|May 6, 2008
Summary
One-lung ventilation (OLV) can cause lung injury. This review explores how adjusting ventilation settings may reduce risks during procedures requiring OLV.
Area of Science:
- Anesthesiology and Critical Care Medicine
- Respiratory Physiology
Background:
- One-lung ventilation (OLV) is a critical technique for thoracic and minimally invasive surgeries.
- Evidence suggests OLV can lead to acute lung injury (ALI) beyond V/Q mismatch.
- Understanding OLV's physiological impact is crucial for patient safety.
Purpose of the Study:
- To review the physiological basis of OLV.
- To examine evidence supporting modifications to ventilatory parameters for protective OLV.
- To consolidate knowledge on mitigating OLV-induced lung injury.
Main Methods:
- Literature review of OLV physiology.
- Analysis of studies investigating ventilatory strategies during OLV.
- Synthesis of evidence on protective ventilation parameters.
Main Results:
- OLV significantly disrupts ventilation-perfusion (V/Q) matching.
- Accumulating evidence links OLV to the development of acute lung injury.
- Specific ventilatory parameter adjustments show potential for lung protection.
Conclusions:
- Protective strategies during OLV are necessary to minimize lung injury.
- Further research into optimizing ventilatory parameters for OLV is warranted.
- Implementing protective OLV may improve patient outcomes in thoracic procedures.
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