Introduction One-lung ventilation (OLV) is a standard procedure required in thoracic surgery for cancer resection, treatment of bronchopulmonary fistula or bleeding, and lung transplantation, as well as for intrathoracic diagnostic investigations. Over the past 3 decades, the incidence of intraoperative…
Introduction The term high-frequency ventilation (HFV) summarizes different techniques of ventilation with a ventilator frequency of more than 60 breaths per minute, tidal volumes (V T ) of equal or less than dead space, as well as lower peak airway…
Introduction The complex cardiopulmonary interactions, combined with abnormal secretion and surgical impairment of lung-chest wall dynamics makes hypoxemia, hypo- and hypertension, dysrhythmia, hypercapnia, and acidosis common threats in the perioperative period. Bronchoscopy by definition is a procedure that allows for…
Introduction Thoracic surgery is a rapidly changing surgical subspecialty that presents the anesthesiology community with a myriad of challenges, one of which is hemodynamic monitoring. Thoracic surgical patients range from relatively healthy adults with refractory gastroesophageal reflux in need of…
Introduction During anesthesia for a thoracic surgical procedure, many alterations in physiology occur, including changes in oxygenation and ventilation. Whether the patient is receiving monitored anesthesia care (MAC), regional anesthesia, or general anesthesia, it is essential that the anesthesiologist monitor…
Introduction Adequate patient position is essential to facilitate surgical exposure. This in turn has direct consequence on the anesthetic management. In addition to providing best access to the patient, optimal position should minimize any potential harm and injuries, especially when…
Introduction Lung cancer accounts for 30% of all cancer cases, with outcomes for patients improving at a modest pace. That said, 5-year survival for patients with stage IA to IIA cancer managed with a combination of chemotherapy and surgery exceeds…
Introduction The main purposes of a comprehensive preoperative evaluation before thoracic surgery are to assess the risk associated with anesthesia and surgery throughout the perioperative period; to identify, modify, and optimize the treatment of comorbidities that may affect perioperative outcome;…
Introduction Thoracic surgery commonly requires the separation of the patient’s airway, followed by exclusion of one lung from ventilation (i.e., one-lung ventilation [OLV]) to facilitate surgical interventions. However, ventilation of one lung will result in an increased intrapulmonary shunt because…
Introduction Thoracic procedures are usually performed with the patient in the lateral decubitus position. To understand the distribution of ventilation and perfusion in the lateral decubitus position and the degree of venous admixture of shunt (Qs/Qt) is expressed as a…