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Updated: Oct 24, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Application of Continuous Positive Airway Pressure During Video-Assisted Thoracoscopic Surgery
Javier H Campos1, Dionne Peacher2
1Department of Anesthesia, University of Iowa Carver College of Medicine, University of Iowa Healthcare, 200 Hawkins Drive, Iowa City, IA 5221 USA.
Purpose Of Review:
Video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS) are used for anatomic resection of early stage cancer. These surgical techniques require the use of one-lung ventilation (OLV). During OLV, an obligatory intrapulmonary shunt may produce hypoxemia. One method to correct hypoxemia is with the use of continuous positive airway pressure (CPAP). This review focuses on 1) the lung physiology of OLV; 2) application of CPAP in VATS or RATS during supine and lateral position; and 3) the application of CPAP in COVID-19 patients during OLV.
Recent Findings:
Studies have shown the beneficial effects of CPAP to improve oxygenation during OLV while the patient is in the lateral decubitus position. In contrast, studies have shown no benefit on improving oxygenation with CPAP in patients undergoing OLV in supine position.
Summary:
The application of CPAP to the non-dependent lung is one of the options to treat hypoxemia during VATS or RATS.
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