One-lung ventilation does not result in cerebral desaturation during application of lung protective strategy if normocapnia is maintained

Background: Previously a report has suggested that administration of lung protective strategy for one-lung ventilation (OLV) results in oxygen desaturation of the brain parenchyma. The aim of our work was to con firm that the maintenance of cormocapnia during protective OLV strategy results in alteration of cerebral blood flow and cerebral oxygen naturation as compared to double-lung ventilation. Methods: Data were obtained from 24 patients undergoing thoracic surgery. Cerebral oxygen saturation (rSO2) was continuously monitored by INVOS 5100C Cerebral Oxymeter System along with measurement of cerebral blood flow velocity (MCAV) by transcranial Doppler sonography. Arterial blood samples were taken for blood gas analysis in the awake state, in the supine and lateral decubitus position during double-lung ventilation (DLV), and during OLV. Results: When ventilation was changed from DLV to OLV, no signifi cant change was observed in rSO 2. A significant decrease of rSO2 was found compared to the value observed during DLV in lateral decubitus at the time point 60 minutes after the start of OLV. No clinically signifi cant changes in the MCAV was observed throughout the course of the thoracic surgical procedure. Conclusions: OLV does not result in clinically relevant decreases in cerebral blood flow and cerebral oxygen saturation during application of lung protective ventilation if normocapnia is maintained.