[Anaesthetic problems during resection of the carina (author's transl)]

Benigne tracheo-bronchial constriction is an infrequent indications for resection of the bifurcation of the trachea. In former times resection and reconstruction of the bifurcation have been performed using extracorporal oxygenation. Nowadays, the method of separate ventilation of both lungs is used more frequently. Pathophysiological variations should be taken into consideration, which may occur during interruption of the ventilation of one side of lung caused by operating procedures. Rapidly developing atelectasis of the non-ventilated but perfused lung endangers the patient, as a result of an increased intrapulmonary right-to-left-shunt. Hypoxaemia can be prevented by temporary occlusion of the pulmonary artery of the nonventilated lung. This procedure is to be recommended in view of the fact that there is no prompt constriction of the vessels. Investigations with dogs show that a slightly developing accommodation of the perfusion can be disturbed by variations of cardiac output or mean pressure of ventilation.