Anaesthesia for Video-Assisted and Robotic Thoracic Surgery
Highlights
- Although the lung will not ‘collapse’ until the pleura is breached, volume loss can be encouraged before surgical incision, increasing pleural retraction pressure and theoretically reducing the risk of direct lung injury at the time of surgical port insertion (View Highlight)
- in thoracic surgery, there is a direct association between duration of OLV and risk of PPC (View Highlight)
- Techniques for improving lung collapse include:
• (i)
ventilating the lungs with 100% O2 before lung isolation to remove nitrogen from the operative lung
• (ii)
application of suction to the operative lung: if collapse is difficult in individual lobes, suction can be directed using the fibreoptic bronchoscope to ensure the large airways are clear of secretions. (View Highlight)