A systematic review of one-lung ventilation during thoracic surgery comparing the safety and efficacy of high and low tidal volumes

Background/Introduction Lung isolation, a technique largely used to facilitate access during thoracic surgery, can create some difficulty in maintaining a patient’s blood gas balance. Strategies have been used to overcome the ventilation-perfusion mismatch associated with one-lung ventilation (OLV). However, such strategies may induce volutrauma, barotrauma and atelectotrauma in the ventilated lung, leading to acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS). Different ventilatory parameters have been used to improve the safety and efficacy of OLV, with the use of high or low tidal volumes (VT) being the most contentious.