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Review
. 2021;11(4):414-420.
doi: 10.1007/s40140-021-00470-5. Epub 2021 Jul 7.

Hypoxemia During One-Lung Ventilation: Does It Really Matter?

Chris Durkin  1 , Kali Romano  1 , Sinead Egan  1 , Jens Lohser  1
Affiliations
Review

Hypoxemia During One-Lung Ventilation: Does It Really Matter?

Chris Durkin et al. Curr Anesthesiol Rep. 2021.

Abstract

Purpose of review: Hypoxemia during one-lung ventilation, while decreasing in frequency, persists as an intraoperative challenge for anesthesiologists. Discerning when desaturation and resultant hypoxemia correlates to tissue hypoxia is challenging in the perioperative setting and requires a thorough understanding of the physiology of oxygen delivery and tissue utilization.

Recent findings: Oxygen delivery is not directly correlated with peripheral oxygen saturation in patients undergoing one-lung ventilation, emphasizing the importance of hemoglobin concentration and cardiac output in avoiding tissue hypoxia. While healthy humans can tolerate acute hypoxemia without long-term consequences, there is a paucity of evidence from patients undergoing thoracic surgery. Increasingly recognized is the potential harm of hyperoxic states, particularly in the setting of complex patients with comorbid diseases.

Summary: Anesthesiologists are left to determine an acceptable oxygen saturation nadir that is individualized to the patient and procedure based on an understanding of oxygen supply, demand, and the consequences of interventions.

Keywords: Hypoxemia; Hypoxia; One-lung ventilation; Oxygen delivery; Thoracic anesthesia.

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Conflict of interest statement

Conflict of InterestThe authors do not have any potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
DO2 was not correlated with SaO2 during OLV. Reproduced with permission from Hahm et al [•].
See this image and copyright information in PMC

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