• Sang Hun Kim, Ki Tae Jung, and Tae Hun An.
• Department of Anesthesiology and Pain Medicine, Chosun University Medical School, 588 Seasuk-dong, Donggu, Gwangju, 501 717, Korea.
• J Anesth. 2012 Aug 1;26(4):568-73.

PurposeThe main problem of one-lung ventilation (OLV) is hypoxemia. The use of a high tidal volume for preventing hypoxemia during OLV is controversial. We compared the effects of a high tidal volume versus a low tidal volume with or without PEEP on arterial oxygen tension (PaO(2)) and pulmonary mechanics during OLV.MethodsSixty patients (age range, 16-65 years; ASA I, II) who underwent wedge resection with video-assisted thoracostomy during OLV were assigned to three groups: group I received a high tidal volume (10 ml/kg) (n = 20), group II received a low tidal volume (6 ml/kg) (n = 20), and group III received a low tidal volume (6 ml/kg) with PEEP (5 cmH(2)O) (n = 20). Patient hemodynamics, pulmonary mechanics, and arterial blood gases were measured before (T(0)) OLV and 5 (T(1)), 15 (T(2)), 30 (T(3)), and 45 min (T(4)) after OLV.ResultsThe PaO(2)/FiO(2) ratios of group II and III were significantly decreased and the incidence of hypoxemia was significantly higher in groups II and III than in group I (P < 0.05).ConclusionDuring OLV, mechanical ventilation with a low tidal volume with or without PEEP increased hypoxemia as compared to that when performing OLV with a high tidal volume.

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