Lung Isolation

Abstract

Lung isolation is being used more frequently in adult patients due to increasing incidence of thoracoscopy and video-assisted thoracoscopic surgery. There are several indications for lung isolation and one-lung ventilation (OLV) during surgery. Isolation is usually achieved by double-lumen endotracheal tubes or use of some type of bronchial blocker system. The initiation of OLV frequently leads to hypoxemia, the management of which should be stepwise. Additionally, clinical outcomes are significantly improved with the use of lung protective strategies during OLV. This review covers the use of few of the most common lung isolation devices, management of OLV using lung protective ventilation strategies, and management of oxygenation and hypoxemia during OLV. This review contains 12 figures, 6 tables, and 36 references. Key Words: bronchial blockers, double-lumen tube, uninvent, hypoxemia, hypoxic pulmonary vasoconstriction, one lung ventilation, positive end expiratory pressure, tracheal anatomy, lung isolation