Changes in ventilation strategies during thoracic surgery: Do we have to focus “only” in oxygenation?
Anesthesia in Thoracic Surgery: Changes of Paradigms, Springer International Publishing Ag, ss.153-164, 2020
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2020
- Doi Numarası: 10.1007/978-3-030-28528-9_12
- Yayınevi: Springer International Publishing Ag
- Sayfa Sayıları: ss.153-164
- Anahtar Kelimeler: Hypoxemia, One lung ventilation, Protective ventilation
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
Two major challenges should be considered during one-lung ventilation (OLV): Hypoxemia and lung injury. The former is mainly because the increase in intrapulmonary shunt; the latter is mainly because volo-, baro, atelecto-, and biotraumas. The so-called “protective ventilation”, consisting of low tidal volume, PEEP and recruitment manoeuvres can help to deal with these challenges. Low FiO2, CPAP to the non-dependent lung are other recommendations, but they have limits in daily practice. There is no particular ventilatory mode to recommend. Inhalational anaesthetics can have a “slightly” negative effect on oxygenation, but have benefits regarding the inflammatory response.