One-Lung Ventilation and Acute Lung Injury

Thoracic surgery and OLV certainly are accompanied by unique intraoperative physiology. Although these intraoperative conditions are necessary for successful surgery, they impose risks for perioperative pulmonary complications and ALI. The clinical team caring for these patients in the perioperative period must understand what can be done to minimize therapies that could lead to any further increased risk for complications. To this effect, we encourage the use of a thoughtful management strategy, as described above. Through the incorporation of lung-protective ventilation, acceptance of adequate, as opposed to optimal oxygenation and ventilation, reasonable restriction of fluids and blood products, and the augmentation of hemodynamics via inotropic and vasopressors support, as end-organ function necessitates, patient risk can be minimized to allow for optimal outcome and recovery. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.