![]() ![]() ![]() Monitoring dead space helps anesthesiologists monitor the status of the lung and find appropriate ventilatory settings during thoracic surgeries. Therefore, continuous assessment of dead space is helpful in guiding ventilation and avoiding overdistension while maintaining the elimination of CO(2) during thoracic surgery sufficiently high. When there’s a mismatch between airflow (ventilation) and blood flow (perfusion), this leads to a condition called dead space ventilation. However, such a ventilatory strategy impairs ventilation and induces hypercapnia due to increases in dead space. Compromised blood flow, or lung tissue that cannot be adequately filled with air, both affect function. It has been shown to reduce the incidence of postoperative pulmonary complications after thoracic surgeries. To date, lung protective ventilation is based on the use of low tidal volumes and airway pressures to decrease overdistension. This type of injury threatens the fragile lungs especially during one-lung ventilation and can clinically be recognized as an increase in airway and alveolar dead space above normal values. Another interesting use of such monitoring is to detect ventilator-induced lung injury due to tidal overdistension. Monitoring dead space during thoracic surgery assesses the ventilatory deficiencies related to increases in instrumental, airway and/or alveolar dead space, when ventilating patients with positive pressure and double-lumen tubes. The concept of dead space has gained renewed interest among anesthesiologists ever since breath-by-breath measurement by volumetric capnography became available. Describe the importance of monitoring dead space during thoracic surgery, specifically during one-lung ventilation. ![]()
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