Single-Lung Ventilation

Excerpt

Single-lung ventilation, also known as 'one-lung' ventilation, involves ventilating one lung and letting the other collapse to provide surgical exposure in the thoracic cavity or isolating ventilation to one lung. The protective role of single-lung ventilation involves protecting one lung from the ill effects of fluid from the other lung, which may be blood, lavage fluid, or malignant or purulent secretions. Thus, perfect placement of the tube is essential, as a misplaced tube defeats the goal of lung isolation or differential ventilation. Bronchoscopy after tube placement ensures proper placement.

Single-lung ventilation is used to facilitate procedures on ipsilateral thoracic or mediastinal structures and to provide lung isolation; this is made possible by using double-lumen tubes, bronchial blockers, and endobronchial tubes. Familiarity with the use of these instruments and the physiology of single-lung ventilation is essential to the performance of safe anesthesia.

This article will discuss the anatomy and physiology of single-lung ventilation, its indication/contraindications, equipment, and preparation. Traditional mechanical ventilation will be discussed separately.