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Updated: Jun 5, 2026

Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
Apnoeic oxygenation on one-lung ventilation in functionally impaired patients during sleeve lobectomy
David Sanchez-Lorente1, Abel Gómez-Caro, Maria Jose Jimenez
1General Thoracic Surgery Department, Instituto del Tórax, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain.
Abstract:
We describe a useful salvage method for hypoxaemia during one-lung ventilation (OLV) in functionally impaired patients during a sleeve bronchial reconstruction. When dependent-lung OLV strategies for hypoxaemia fail during bronchial anastomosis (increasing the oxygen administration to fraction of inspired oxygen (FiO(2)) 1 and positive end-expiratory pressure (PEEP), recruitment strategy and perfusion modulation), a very simple and efficient method for oxygen administration to the non-dependent lung can be easily employed. Oxygen flow of 5-10 l min(-1) administered by a paediatric intra-field catheter placed in the distal bronchi during bronchial anastomosis of the spared lobe(s), following the principles of apnoeic (hyper)oxygenated ventilation, successfully improves oxygenation without significant impairment of the operation field.
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