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General principles of one lung ventilation

Martin Ma, MD
Peter D Slinger, MD, FRCPC
Section Editor
Roberta Hines, MD
Deputy Editor
Nancy A Nussmeier, MD, FAHA


In most patients requiring mechanical ventilation, both lungs are inflated and deflated together. One lung ventilation (OLV) refers to mechanical separation of the two lungs to allow ventilation of only one lung, while the other lung is compressed by the surgeon or allowed to passively deflate. OLV is a standard approach to facilitate surgical exposure for pulmonary and other thoracic surgeries, or may be used to isolate a pathologic from a healthy lung to prevent soiling or to allow differential ventilation.

This topic will discuss the general principles and physiology of OLV, its management, and complications. Devices used for OLV, their placement and comparative performance are reviewed separately. (See "Lung isolation techniques".)


One lung ventilation (OLV) is used either to improve exposure to the surgical field in thoracic surgery, or to anatomically isolate one lung from a pathologic process of the other lung. Contraindications to OLV include dependence on bilateral mechanical ventilation, and intraluminal airway masses that restrict access to the tracheobronchial tree.


Surgical exposure — An immobile, collapsed lung in the vicinity of the surgical field improves access to the thoracic cavity; thus, OLV is used during many thoracic surgical procedures:

Pulmonary resection, including pneumonectomy, lobectomy, and wedge resection

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Literature review current through: Oct 2017. | This topic last updated: Oct 08, 2017.
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