Arterial oxygen desaturation during one-lung ventilation in a patient with segmental pulmonary infarction.

Abstract

A left thoracotomy for decortication of an infected haemothorax was performed on a 52-year-old man with a partially infarcted left lower lobe that occurred as a rare complication of a pulmonary venous embolus. Before the completion of surgery, after an uncomplicated 40 minutes of one-lung ventilation, the left lung was temporarily re-expanded to assess air leak. On the resumption of one-lung ventilation the SpO2 fell rapidly to 85%, despite apnoeic oxygenation of the non-ventilated lung. In the absence of evidence of double-lumen tube displacement, intra-pulmonary shunting as a consequence of impaired hypoxic pulmonary vasoconstriction in the newly expanded markedly pathological lung is considered the most likely mechanism.

• Authors: J Pfitzner, D G Lance, M J Peacocks
• Journal: Anaesthesia and intensive care (Anaesth Intensive Care) Vol. 33 Issue 6 Pg. 801-4 (Dec 2005) ISSN: 0310-057X [Print] United States
• PMID: 16398388 (Publication Type: Case Reports, Journal Article)

Chemical References

• Oxygen

Topics

• Blood Gas Analysis
• Follow-Up Studies
• Hemothorax (diagnostic imaging, surgery)
• Humans
• Intraoperative Complications (diagnosis, therapy)
• Male
• Middle Aged
• Oxygen (blood)
• Oxygen Inhalation Therapy (methods)
• Pneumonectomy (adverse effects, methods)
• Positive-Pressure Respiration (methods)
• Pulmonary Embolism (diagnostic imaging, surgery)
• Risk Assessment
• Thoracotomy (adverse effects, methods)
• Tomography, X-Ray Computed
• Treatment Outcome