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Table 2.2

Table 2.2Indications for Single-Lung Ventilation
Absolute
1. To isolate from spillage or contamination

  • Infection: bronchiectasis and lung abscess

  • Massive hemorrhage

2. To control the distribution of ventilation

  • Bronchopleural fistula

  • Bronchopleural cutaneous fistula

  • Giant unilateral lung cyst or bulla

  • Tracheobronchial tree disruption or trauma

  • Surgical procedures on major conducting airway (i.e., pneumonectomy or sleeve resection)

  • Life-threatening hypoxemia resulting from unilateral lung disease

  • Unilateral bronchopulmonary lavage (pulmonary alveolar proteinosis)

3. To facilitate surgical exposure

  • Video- and robotic-assisted thoracoscopic surgery

Relative
1. Facilitation of surgical exposure—high priority

  • Thoracic aortic aneurysm

  • Pneumonectomy

  • Upper lobectomy

  • Mediastinal exposure

  • Pulmonary resection via median sternotomy

2. Facilitation of surgical exposure—low priority

  • Esophageal resection

  • Middle and lower lobectomies and segmental resection

  • Procedures on the thoracic spine

3. Severe hypoxemia resulting from unilateral lung disease