Physiology of One Lung Ventilation and Hypoxemia
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During one lung ventilation (OLV), blood flow is shunted to the non-ventilated lung causing hypoxemia. Anesthetics mildly inhibit hypoxic pulmonary vasoconstriction (HPV), increasing shunt by around 4%. Positioning and techniques like selective lung ventilation and PEEP can optimize ventilation and perfusion matching to minimize hypoxemia during OLV.
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