title: Anesthesia case management for video-assisted thoracoscopic surgery.
abstract: As the population ages, the number of patients in whom lung disease develops and who require surgical intervention will continue to rise. When compared with open thoracotomy, video-assisted thoracoscopic surgery (VATS) offers patients significant advantages. Decreased invasiveness results in less blood loss, a lower rate of infection, and less postoperative pain and allows for quicker recovery. A description of the significant physiologic changes related to pulmonary blood flow, ventilation, and perfusion when patients are placed in the lateral decubitus position is included. A common method of providing one-lung ventilation during VATS is via a double-lumen endotracheal tube. Proper use, placement, ventilation strategies, and methods to minimize the incidence and treat hypoxia for a double-lumen tube are reviewed. One-lung ventilation poses significant challenges for anesthetists. As a result, adequate preparation during the preoperative, intraoperative, and postoperative phases is essential.
authors.affiliation: Kaiser Permanente, Panorama City, California, USA.
authors.forename: Loretta
authors.initials: L
authors.lastname: Kitabjian
authors.forename: Sandy
authors.initials: S
authors.lastname: Bordi
authors.forename: Sass
authors.initials: S
authors.lastname: Elisha
authors.forename: Mark
authors.initials: M
authors.lastname: Gabot
authors.forename: Jeremy
authors.initials: J
authors.lastname: Heiner
authors.forename: John
authors.initials: J
authors.lastname: Nagelhout
authors.forename: Jennifer
authors.initials: J
authors.lastname: Thompson
mesh_terms: D000758:Anesthesia / Q000379:methods*; D019090:Case Management; D006801:Humans; D000860:Hypoxia / Q000517:prevention & control; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures; D061810:One-Lung Ventilation / Q000295:instrumentation / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D056888:Patient Positioning; D019990:Perioperative Care; D011187:Posture / Q000502:physiology; D011652:Pulmonary Circulation; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects