1. Inspired Oxygen Fraction.
   1. An Fio ₂ (fraction of inspired oxygen) of 1.0 is generally recommended during OLV. High oxygen concentration serves to protect against hypoxemia during the procedure and provides a higher margin of safety.
   2. A high Fio ₂ may, however, cause absorption atelectasis and potentially further increase the amount of shunt because of the collapsed alveoli.
2. Tidal Volume and Respiratory Rate. It has been recommended that during OLV, the dependent lung be ventilated with a tidal volume of 10 to 12 mL/kg. (Low tidal volumes may be recommended to avoid overdistension of alveoli and acute lung injury.)
3. Positive End-expiratory Pressure to the Dependent Lung. Combining low TV with a small amount of positive end-expiratory pressure (PEEP) (5 cm H₂O) to protect from development of atelectasis is the currently recommended ventilatory strategy.
4. Continuous Positive Airway Pressure to the Nondependent Lung
   1. A lower level of continuous positive airway pressure (CPAP) (5–10 cm H₂O) maintains the patency of the nondependent lung alveoli, allowing some oxygen uptake to occur in the distended alveoli.
   2. Most thoracic procedures are initiated thoracoscopically, and the application of CPAP to the nondependent lung is generally not acceptable to most surgeons.

Anesthesia for Thoracic Surgery

1. Preoperative Evaluation
2. Preoperative Preparation
3. Intraoperative Monitoring
4. One-Lung Ventilation
5. Management of One-Lung Ventilation
6. Clinical Approach to Management of One-Lung Ventilation
7. Choice of Anesthesia for Thoracic Surgery
8. Hypoxic Pulmonary Vasoconstriction
9. Anesthesia for Diagnostic Procedures
10. Anesthesia for Special Situations
11. Myasthenia Gravis
12. Postoperative Management and Complications