oneLungVentilation - Use of One-Lung Ventilation for...

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Use of One-Lung Ventilation for Thoracic Surgery Yanping Duan, M.D., CA-2 Charles Smith, M.D. Department of Anesthesiology MetroHealth Medical Center
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Objectives Indication/contraindication of OLV Physiology changes of OLV Selection of the methods for OLV Management of common problems associated with OLV, especially hypoxemia
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Introduction One-lung ventilation, OLV, means separation of the two lungs and each lung functioning independently by preparation of the airway OLV provides: Protection of healthy lung from infected/bleeding one Diversion of ventilation from damaged airway or lung Improved exposure of surgical field OLV causes: More manipulation of airway, more damage Significant physiologic change and easily development of hypoxemia
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Indication Absolute Isolation of one lung from the other to avoid spillage or contamination Infection Massive hemorrhage Control of the distribution of ventilation Bronchopleural fistula Bronchopleural cutaneous fistula Surgical opening of a major conducting airway giant unilateral lung cyst or bulla Tracheobronchial tree disruption Life-threatening hypoxemia due to unilateral lung disease Unilateral bronchopulmonary lavage
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Indication (continued) Relative Surgical exposure ( high priority) Thoracic aortic aneurysm Pneumonectomy Upper lobectomy Mediastinal exposure Thoracoscopy Surgical exposure (low priority) Middle and lower lobectomies and subsegmental resections Esophageal surgery Thoracic spine procedure Minimal invasive cardiac surgery (MID-CABG, TMR) Postcardiopulmonary bypass status after removal of totally occluding chronic unilateral pulmonary emboli Severe hypoxemia due to unilateral lung disease
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Physiology of the LDP Upright position LDP, lateral decubitus position
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Awake/closed chest Anesthetized . V
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oneLungVentilation - Use of One-Lung Ventilation for...

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