Thoracic anaesthesia and one-lung ventilation

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Target exams

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.