What is one-lung ventilation and in what surgery is it used?

• A. Ventilating both lungs; used in abdominal surgery.
• B. Ventilating only one lung to provide adequate surgical exposure; used in thoracic procedures.
• C. Ventilating lungs alternately; used in neurosurgery.
• D. Not used in modern anesthesia.

Answer: (B)

One-lung ventilation isolates and ventilates only the nonoperative lung while the operative lung is allowed to collapse, giving the surgeon a clear, unobstructed view and more space to work inside the chest. This is typically achieved with a specialized double-lumen endotracheal tube or a bronchial blocker that separates the two lungs. By keeping one lung inflated and oxygenated, the patient maintains gas exchange even while the other lung is collapsed for surgical access.

This technique is used primarily in thoracic procedures, where access to the chest cavity is needed and the operative field benefits from lung deflation—examples include lung resections such as lobectomy or pneumonectomy, esophageal surgery, and certain mediastinal or thoracic spine procedures.

The other approaches described—ventilating both lungs, alternating ventilation, or claiming it isn’t used—do not provide the necessary lung isolation and exposure required for these surgeries.