Introduction: Lung isolation techniques and one-lung ventilation (OLV) are essential in thoracic surgery, enabling selective ventilation and lung collapse to protect the contralateral lung and facilitate surgical exposure. Their historical evolution spans from rudimentary devices to modern double-lumen tubes (DLT) and bronchial blockers (BB). Objective: To review the indications, devices, and anesthetic management during OLV, emphasizing strategies to prevent complications such as hypoxemia and lung injury. Methods: A narrative review based on medical literature, addressing historical perspectives, absolute and relative indications, and technical features of DLTs and BBs. Intraoperative management is detailed, including optimization of ventilation/perfusion (V/Q) ratios, hypoxemia management, and prevention of respiratory distress. Conclusions: Lung isolation techniques remain the gold standard in anesthesia for thoracic surgery. Device selection depends on anatomical and surgical factors, with specific advantages for DLTs (speed, fiberoptic access) and BBs (versatility in difficult airways). Hypoxemia during OLV is common and requires multimodal management. Protective ventilation reduces the risk of respiratory distress. Procedural success hinges on integrating isolation techniques, rigorous monitoring, and individualized physiological management.
Contreras Barrios., P. ., & Venegas Landaida, K. . (2025). Lung isolation techniques and one-lung ventilation. Boletín De Anestesia, (5), pp. 29–33. Retrieved from https://boletinanestesia.uchile.cl/index.php/BA/article/view/81314
