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AANA J. 2013 Feb;81(1):65-72.

Anesthesia case management for video-assisted thoracoscopic surgery.

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  • 1Kaiser Permanente, Panorama City, California, USA.


As the population ages, the number of patients in whom lung disease develops and who require surgical intervention will continue to rise. When compared with open thoracotomy, video-assisted thoracoscopic surgery (VATS) offers patients significant advantages. Decreased invasiveness results in less blood loss, a lower rate of infection, and less postoperative pain and allows for quicker recovery. A description of the significant physiologic changes related to pulmonary blood flow, ventilation, and perfusion when patients are placed in the lateral decubitus position is included. A common method of providing one-lung ventilation during VATS is via a double-lumen endotracheal tube. Proper use, placement, ventilation strategies, and methods to minimize the incidence and treat hypoxia for a double-lumen tube are reviewed. One-lung ventilation poses significant challenges for anesthetists. As a result, adequate preparation during the preoperative, intraoperative, and postoperative phases is essential.

[PubMed - indexed for MEDLINE]
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