Anaesthesiological management of one-lung anaesthesia

作者：Spieth P M^*; Koch T; de Abreu M Gama

来源：Anasthesiologie & Intensivmedizin, 2009, 50: 86-+.

• One-Lung Anaesthesia
• Independent Lung Ventilation
• Hypoxic Pulmonary Vasoconstriction
• Respiratory Management

Although one-lung anaesthesia is now a standard procedure, it may still challenge the anaesthesiologist. Apart from the sometimes difficult airway management, complex physiological interactions make management of the respiration of decisive importance. While the avoidance of intraoperative hypoxaemia and hypercapnia is an overriding requirement, a respiratory strategy aimed at protecting against the risk of ventilator induced lung injury should also be applied. Such additional measures as the routine use of fiberoptic bronchoscopy, restrictive fluid regimens, thoracic epidural anaesthesia or variable ventilation can help minimise complications and further improve outcome. This article also reviews the underlying physiological aspects of respiration and their changes during one-lung anaesthesia, as well as common problems and pitfalls in the clinical setting. On the basis of the current state of our knowledge an algorithm for the implementation of one-lung anaesthesia is presented.

• 出版日期2009-2