Case scenario: Management of intraoperative hypoxemia during one-lung ventilation.

H YPOXEMIA that may reasonably be defined by an arterial hemoglobin oxygen saturation of less than 90% occurs in 5–10% of patients during one-lung ventilation (OLV). The physiopathology of hypoxemia is complex, and the management of intraoperative hypoxemia during OLV remains a challenge for anesthesiologists. In life-threatening hypoxemia, correct oxygenation should be restored rapidly. This may require discontinuing surgery to eliminate reversible causes of hypoxemia. Several strategies can then be applied to prevent and correct hypoxemia during OLV.