Skip to main content
MedVellum
QuestionsVideosPricing

MedVellum

Fellowship exam preparation across every specialty: source-verified topics, questions in every format, and videos.

Product

  • Specialties
  • Questions
  • Videos
  • Exam tools
  • Pricing

Verification & policy

  • Verified register
  • Editorial policy
  • Privacy
  • Terms

Account

  • Sign in
  • Create account
  • Dashboard
  • Account & billing

© 2026 MedVellum. For education only — not a substitute for clinical judgement.

llms.txtPsychiatry LLM catalogSitemap

Anaes TopicsThoracic anaesthesia & one-lung ventilation

Anaes · Thoracic anaesthesia & one-lung ventilation

Thoracic anaesthesia and one-lung ventilation

Also known as One-lung ventilation · Double-lumen tube · Bronchial blocker · OLV hypoxaemia · SS_TS specialised study unit

Exam-pass thoracic anaesthesia hub (SS_TS): left DLT vs bronchial blocker, HPV and OLV hypoxaemia algorithm, protective ventilation, mediastinal mass rescue plan, and leaf links for VATS analgesia and lung isolation.

high8 referencesUpdated 26 July 20266 min readVerification in progress

Practise this topic

  • 12 MCQs

Your progress

Saved on this device.

Practise this topic12 MCQs with explanations

Target exams

ANZCAFRCAABAEDAICFCAIFCA_SA

Red flags

  • OLV hypoxaemia is algorithmic: FiO2 1.0 → fiberoptic position check → suction → PEEP to ventilated lung → CPAP to operative lung → recruitment → resume two-lung if needed.
  • Left-sided DLT is default (greater margin of safety); always confirm with fiberoptic bronchoscopy.
  • Anterior mediastinal mass: risk of catastrophic airway/vascular collapse on induction — preserve spontaneous ventilation, have rigid bronchoscope/femoral bypass plan in high risk.
  • Volatiles inhibit HPV dose-dependently; severe hypoxaemia may favour TIVA and HPV preservation strategies.
  • Protective OLV: tidal volume ~4–6 mL/kg PBW with PEEP; avoid driving pressure injury.
On this page
Study tools

Your progress

Saved on this device.

Practise this topic12 MCQs with explanations

Target exams

ANZCAFRCAABAEDAICFCAIFCA_SA

Red flags

  • OLV hypoxaemia is algorithmic: FiO2 1.0 → fiberoptic position check → suction → PEEP to ventilated lung → CPAP to operative lung → recruitment → resume two-lung if needed.
  • Left-sided DLT is default (greater margin of safety); always confirm with fiberoptic bronchoscopy.
  • Anterior mediastinal mass: risk of catastrophic airway/vascular collapse on induction — preserve spontaneous ventilation, have rigid bronchoscope/femoral bypass plan in high risk.
  • Volatiles inhibit HPV dose-dependently; severe hypoxaemia may favour TIVA and HPV preservation strategies.
  • Protective OLV: tidal volume ~4–6 mL/kg PBW with PEEP; avoid driving pressure injury.
The one-line answer

Thoracic anaesthesia is isolation plus physiology: choose and confirm the DLT or blocker, protect the ventilated lung, run the OLV hypoxaemia algorithm in order, and never induce a critical mediastinal mass without a spontaneous-ventilation and rescue plan.[1][3]

Meet the patient

A 68-year-old smoker with a right upper lobe tumour is positioned left lateral for VATS lobectomy. You place a 37 Fr left DLT, confirm with fiberoptic bronchoscopy, and the surgeon asks you to go to one lung. Five minutes later, SpO2 is 88%.[1]

The examiner's question: "Walk me through your hypoxaemia algorithm — in order." This topic lives or dies on whether you check the tube before you blame the physiology.[1][3]

Anaesthesia Pro

Continue reading

You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Anaesthesia fellowship library.

Sign in to continueSee pricing
References8ShowHide
  1. [1]Granell M, et al. Airway Management in Thoracic Anesthesia: EACTAIC Consensus Document J Cardiothorac Vasc Anesth, 2026.PMID 41353026
  2. [2]Lumb AB, Slinger P Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications Anesthesiology, 2015.PMID 25587641
  3. [3]Shum S, Huang A, Slinger P Hypoxaemia during one lung ventilation BJA Educ, 2023.PMID 37600211
  4. [4]Licker M, et al. The hypoxic pulmonary vasoconstriction: From physiology to clinical application in thoracic surgery Saudi J Anaesth, 2021.PMID 34764832
  5. [5]Kremer R, Aboud W, Haberfeld O, et al. Differential lung ventilation for increased oxygenation during one lung ventilation for video assisted lung surgery. J Cardiothorac Surg, 2019.PMID 31060627
  6. [6]Qian M, Cong Z, Yang N, et al. Effect of protective ventilation throughout the intubation period on perioperative oxygenation in patients undergoing MIDCABG: a randomised controlled trial. Ann Med, 2026.PMID 42655964
  7. [7]Xu M, Hu J, Yan J, et al. Paravertebral Block versus Thoracic Epidural Analgesia for Postthoracotomy Pain Relief: A Meta-Analysis. Thorac Cardiovasc Surg, 2022.PMID 33477177
  8. [8]Bussières JS, Gingras M, Perron L, et al. Right upper lobe anatomy revisited: a computed tomography scan study. Can J Anaesth, 2019.PMID 30838521

Test yourself

Practise what you just read

  • 12 MCQs
Anaesthesia Pro

$29/ monthor $279 / year

The complete Anaesthesia library, every exam format, one subscription.

  • Complete library for one chosen specialty
  • Timed MCQ mock exams and spaced review
  • Clinical cases & cross-table vivas
See pricingSign in
PreviousThermoregulationApplied physiology — thermoregulation and heat balanceNextTrauma and massive haemorrhageTrauma and massive haemorrhage