This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ruiz, P. Articles by Kovarik, G. Search for Related Content PubMed PubMed Citation Articles by Ruiz, P. Articles by Kovarik, G.

Lung mechanics and gas exchange in one-lung ventilation following contralateral resection

[La mécanique respiratoire et les échanges gazeux pendant la ventilation unilatérale suivant une résection controlatérale]

From the Department of Anesthesia, Montreal General Hospital, McGill University Health Centre, Montréal, Québec, Canada.

Address correspondence to: Dr. P. Ruiz, Montreal General Hospital, Department of Anesthesia, 1650, avenue Cedar, Room D10 165.3, Montréal, Québec H3G 1A4, Canada. Phone: 514-934-1934, ext. 43261; Fax: 514-934-8249; E-mail: ppruizmd{at}aol.com

Purpose: To describe the anesthetic management of a patient with previous left lower lobe resection who was submitted to a right upper lobectomy and review the changes in gas exchange and respiratory mechanics which occurred intraoperatively.

Clinical features: A 69-yr-old male with lung cancer, emphysema and obstructive sleep apnea, presented for a right upper lobectomy. His history was also positive for a left lower lobectomy six years previously. Intraoperative lung isolation was achieved using a 41 F left double-lumen tube (DLT). Monitoring the respiratory mechanics allowed for continuous adjustment of ventilator settings during the various phases of the surgery avoiding the risks of barotrauma and volutrauma. Problems with oxygenation occurred during one-lung ventilation.

Conclusion: This case report shows that a severe level of hypoxemia and hypercarbia associated to lung mechanical property changes can be observed during the OLV phase. Application of continuous positive airway pressure on the non-dependent lung partially corrected blood oxygenation. Lobe isolation techniques should be considered as useful options for intraoperative airway management for these patients.