title: Intraoperative mechanical ventilation strategies for one-lung ventilation.
abstract: One-lung ventilation (OLV) has two major challenges: oxygenation and lung protection. The former is mainly because the ventilation of one lung is stopped while the perfusion continues; the latter is mainly because the whole ventilation is applied to only one lung. Recommendations for maintaining the oxygenation and methods of lung protection can contradict each other (such as high vs. low inspiratory oxygen fraction (FiO2), high vs. low tidal volume (TV), etc.). In light of the (very few) randomized clinical trials, this review focuses on a recent strategy for OLV, which includes a possible decrease in FiO2, lower TVs, positive end-expiratory pressure (PEEP) to the dependent lung, continuous positive airway pressure (CPAP) to the non-dependent lung and recruitment manoeuvres. Other applications such as anaesthetic choice and fluid management can affect the success of ventilatory strategy; new developments have changed the classical approach in this respect.
authors.affiliation: Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey. Electronic address: senturkm@istanbul.edu.tr.
authors.forename: Mert
authors.initials: M
authors.lastname: Şentürk
authors.affiliation: University of Toronto, Toronto, Canada. Electronic address: Peter.Slinger@uhn.ca.
authors.forename: Peter
authors.initials: P
authors.lastname: Slinger
authors.affiliation: The Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: edmond.cohen@mountsinai.org.
authors.forename: Edmond
authors.initials: E
authors.lastname: Cohen
mesh_terms: D000777:Anesthetics / Q000008:administration & dosage; D000818:Animals; D045422:Continuous Positive Airway Pressure / Q000379:methods; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D061810:One-Lung Ventilation / Q000009:adverse effects / Q000379:methods*; D010100:Oxygen / Q000378:metabolism*; D011659:Pulmonary Gas Exchange; D016032:Randomized Controlled Trials as Topic; D013990:Tidal Volume; D055397:Ventilator-Induced Lung Injury / Q000517:prevention & control*
chemical_list: D000777:Anesthetics; D010100:Oxygen
keywords: mechanical ventilation; one-lung ventilation; pulmonary gas exchange