Challenges in Ventilation in Patients Undergoing Non-Cardiac Thoracic Surgery


Senturk E., CANBAZ M., Senturk M.

CURRENT ANESTHESIOLOGY REPORTS, vol.15, no.1, 2025 (ESCI) identifier identifier

  • Publication Type: Article / Review
  • Volume: 15 Issue: 1
  • Publication Date: 2025
  • Doi Number: 10.1007/s40140-025-00695-8
  • Journal Name: CURRENT ANESTHESIOLOGY REPORTS
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Acibadem Mehmet Ali Aydinlar University Affiliated: Yes

Abstract

Purpose of review This review summarizes the recent literature on hypoxemia and acute lung injury in one-lung ventilation, shedding light on the mechanisms and prevention strategies for these critical complications. It also aims to provide comprehensive guidance for research on acute lung injury, presenting the latest findings to support advancements in this field. Recent findings In one-lung ventilation (OLV) techniques highlight significant advancements in patient outcomes and lung protection strategies. Conventional ventilation, characterized by standard tidal volumes, has been largely overshadowed by protective lung ventilation (PLV) and the open lung approach (OLA) due to the latter methods' superior efficacy in minimizing ventilator-induced lung injury (VILI). PLV utilizes lower tidal volumes and higher positive end-expiratory pressure (PEEP) to reduce alveolar overdistension and collapse, which has been shown to decrease postoperative pulmonary complications. The OLA further enhances lung protection by incorporating recruitment maneuvers and individualized PEEP settings to maintain alveolar stability throughout the procedure. Recent studies suggest that combining PLV and OLA techniques not only improves oxygenation but also attenuates inflammatory responses, leading to better overall clinical outcomes. However, further randomized controlled trials are necessary to solidify these findings and optimize OLV protocols. Summary Protective lung ventilation and the open lung approach in one-lung ventilation (OLV) provide better clinical outcomes by reducing ventilator-induced lung injury.