Anaes Vivas · Thoracic anaesthesia & one-lung ventilation
Data viva — the OLV blood-gas and the shunt fraction
A data viva on the OLV blood gas — the PaO2 below the expected (the shunt from the collapsed perfused lung); the PaCO2 adequate (the ventilation sufficient); the management (the CPAP, the PEEP, the FiO2, the position check).
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Prompt
An arterial blood gas during the right-lung OLV: the PaO2 65 mmHg on the FiO2 100%, the PaCO2 42. Interpret and advise.
Stimulus
An arterial blood gas during the right-lung OLV (the right lung collapsed, the left ventilated): the PaO2 65 mmHg on the FiO2 100 per cent, the PaCO2 42 mmHg, the pH 7.39. The saturation is 92 per cent. Interpret and advise — confirm shunt-fraction arithmetic against local thoracic teaching; the held review covers HPV redirection of flow from the non-ventilated to the dependent lung.[3]
References1ShowHide
- [3]Licker M, et al. The hypoxic pulmonary vasoconstriction: From physiology to clinical application in thoracic surgery. Saudi J Anaesth, 2021.PMID 34764832