Mechanical Protective Ventilation: New Paradigms in Thoracic Surgery

Canbaz M., Şentürk E., ŞENTÜRK N. M.

Journal of Clinical Medicine, vol.14, no.5, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Review
  • Volume: 14 Issue: 5
  • Publication Date: 2025
  • Doi Number: 10.3390/jcm14051674
  • Journal Name: Journal of Clinical Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Directory of Open Access Journals
  • Keywords: one-lung ventilation, thoracic anesthesia, ventilator-associated lung injury
  • Istanbul University Affiliated: Yes

Abstract

One-lung ventilation (OLV) in thoracic anesthesia poses dual challenges: preventing hypoxemia and minimizing ventilator-associated lung injury (VALI). Advances such as fiberoptic bronchoscopy and improved anesthetic techniques have reduced hypoxemia, yet optimal management strategies remain uncertain. Protective ventilation, involving low tidal volumes (4–6 mL/kg), individualized PEEP, and selective alveolar recruitment maneuvers (ARM), seek to balance oxygenation and lung protection. However, questions persist regarding the ideal application of PEEP and ARM, as well as their integration into clinical practice. As for PEEP and ARM, further research is needed to address key questions and establish new guidelines.