Acute intraoperative pulmonary embolism: An unusual cause of hypoxemia during one-lung ventilation

摘要

One-lung ventilation (OLV) induces an obligate right-to-left shunt in the nonyentilated lung and is associated with an impairment of arterial oxygenation. Pulmonary blood flow through the ventilated lung during OLV is augmented by hypoxic pulmonary vasoconstriction (HPV), which limits blood flow to the nonventilated lung and by positional and gravitational effects. The authors report a case in which oxygenation after the institution of OLV was impaired by acute intraoperative pulmonary emboli (PE) directed selectively to the ventilated lung.