Anesthetic Management of One-Lung Ventilation in Thoracic Trauma: A Retrospective Observational Cohort Study.
Video-assisted thoracoscopic surgery linked to lower acute respiratory distress syndrome odds in trauma
Anesthetic Management of One-Lung Ventilation in Thoracic Trauma: A Retrospective Observational Cohort Study.
One-lung ventilation (one-lung ventilation) in acute thoracic trauma presents physiological and technical challenges distinct from elective thoracic anesthesia.
We conducted a retrospective observational cohort study of all trauma patients requiring one-lung ventilation at the Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, over six years (January 2020 to December 2025).
far lower odds of severe lung failure with keyhole surgery than open chest surgery
The mean patient age was 35.8 ± 13.1 years; 93.2% were male.
Road traffic accidents (52.1%) and blunt chest trauma (70.1%) predominated.
Double-lumen tubes were used in 50.4% of cases.
Video-assisted thoracoscopic surgery was associated with a significantly lower acute respiratory distress syndrome rate (10.3% vs 36.2%; P = 0.001) and reduced intraoperative blood transfusion (13.8% vs 31.0%; P = 0.026) compared with open thoracotomy.
One-lung ventilation in thoracic trauma is associated with frequent perioperative hypoxia and postoperative pulmonary complications, with preoperative mechanical ventilation, higher intraoperative FiO₂ requirements, and open thoracotomy independently associated with increased acute respiratory distress syndrome risk, whereas video-assisted thoracoscopic surgery was associated with a lower incidence of acute respiratory distress syndrome.