Anaes Vivas · Thoracic anaesthesia
One-lung ventilation physiology and the hypoxaemia management algorithm — viva
Structured oral examination station for olv-physiology-hypoxaemia-algorithm.
On this page
Study tools
Target exams
ANZCAFRCAEDAICABAFCAI
Prompt
Thoracic theatre stem with DLT in situ; SpO2 85%; EtCO2 rising slightly; surgeon operating on non-dependent lung.
Physiology (3 min)
Explain shunt and HPV per Licker: selective intubation with HPV redirecting upper non-ventilated to dependent flow, biphasic seconds-onset, modifiers listed.[1] Contrast Abe (propofol better PaO2/shunt; shunt fell volatile-to-propofol; 4 cm PEEP raised PaO2)[2] with Pruszkowski BIS nuance (similar PaO2; 16.3 vs 17.7 ns).[3]
References5ShowHide
- [1]Licker M, Hagerman A, Jeleff A, Schorer R, Ellenberger C The hypoxic pulmonary vasoconstriction: From physiology to clinical application in thoracic surgery. Saudi Journal of Anaesthesia, 2021.PMID 34764832
- [2]Abe K, Shimizu T, Takashina M, Shiozaki H, Yoshiya I The effects of propofol, isoflurane, and sevoflurane on oxygenation and shunt fraction during one-lung ventilation. Anesthesia and Analgesia, 1998.PMID 9806702
- [3]Pruszkowski O, Dalibon N, Moutafis M, Jugan E, Law-Koune JD, Laloë PA Effects of propofol vs sevoflurane on arterial oxygenation during one-lung ventilation. British Journal of Anaesthesia, 2007.PMID 17347180
- [6]Maroof M, Khan RM, Bhatti TH CPAP with air and oxygen to non-ventilated lung improves oxygenation during one lung anaesthesia. Journal of the Pakistan Medical Association, 1995.PMID 7602743
- [7]Sentürk M, Layer M, Pembeci K, Toker A, Akpir K, Wiedemann K [A comparison of the effects of 50 % oxygen combined with CPAP to the non-ventilated lung vs. 100 % oxygen on oxygenation during one-lung ventilation]. Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS, 2004.PMID 15197670