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KMID : 0356920160690030279
Korean Journal of Anesthesiology
2016 Volume.69 No. 3 p.279 ~ p.282
Severe hypoxemia during carinal resection in the lateral position under one-lung ventilation of a non-dependent lung: a case report
Koo Chang-Hoon

Jung Yoo-Sun
Lee Yong-Hun
Kim Hyun-Chang
Bahk Jae-Hyon
Seo Jeong-Hwa
Abstract
During one-lung ventilation (OLV) in the lateral position, the dependent, ventilated lung receives more blood flow than the non-dependent, non-ventilated lung owing to gravity, improving the match of ventilation and perfusion. Conversely, in the rare clinical situations when OLV is applied to the non-dependent lung, arterial oxygenation can get worse due to considerable shunt flow to the dependent non-ventilated lung. We report a case of severe hypoxemia during carinal resection under OLV of a non-dependent lung. In this case, OLV had to be applied to the non-dependent lung in the lateral position because the bronchus of the non-dependent lung was anastomosed with the trachea, whereas the bronchus of the dependent lung had already been resected for carinal resection. The subsequent hypoxemia resulting from the shunt flow to the dependent non-ventilated lung was treated successfully by ligating the pulmonary artery of the dependent lung.
KEYWORD
One lung ventilation, Perfusion, Thoracic surgery
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