One Lung Ventilation

Last updated: February 9, 2026

Tidal volume: 4–6 mL/kg of predicted body weight. Remember, lateral positioning means the dependent lung gets 80% of blood flow (up from 60% supine). Higher PEEP may be needed since gravity moves the dependent and non-dependent lungs further down the compliance curve.

When returning to two-lung ventilation, clamp the previously non-ventilated lung so alveolar recruitment does not follow the path of least resistance. Also deflate the bronchial cuff.

Avoid nicardipine — inhibits hypoxic pulmonary vasoconstriction.