Abstract: Background One-lung ventilation(OLV) can provide optimum surgical operating conditions and isolate the lungs to protect them during anesthesia for thoracic surgery. Unfortunately, OLV is a way of ventilation under the non-physiological condition. During the OLV, it often leads to ventilator-induced lung injury(VILI) as a result of barotraumas, oxygen toxicity, and so on. Objective Investigate the preferable strategy of one-lung ventilation for thoracic surgery. Content An alveolar recruitment strategy(ARS) and the lung protective ventilation strategy using low-tidal volumes and the appropriate positive end-expiratory pressure(PEEP) would limit plateau and peak inspiratory pressures(Pplat and Ppeak) to 25 cmH2O(1 cmH2O=0.098 kPa) and 35 cmH2O, respectively. FiO2 should be limited, too. According to the arterial blood gas analysis, respiration rate can be adjusted properly. Trend For the non-operated lung, it can avoid alveolar over-inflation and cyclic recruitment-derecruitment during the OLV. High FiO2 would aggravate oxidative stress, so it is wise to limit FiO2 during OLV. Also, hypercapnia is well tolerated in the short term. Individualized management of patients would create fewer admissions to the intensive care unit and a shorter hospital stay, and improve survival rates and quality of life of them.
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