Radiographic Demonstration of Hypoxic Pulmonary Vasoconstriction during One-lung Ventilation

Education| December 2022 Radiographic Demonstration of Hypoxic Pulmonary Vasoconstriction during One-lung Ventilation Roger L. Royster, M.D.; Roger L. Royster, M.D. 1Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Search for other works by this author on: This Site PubMed Google Scholar Sean D. Johnson, M.D.; Sean D. Johnson, M.D. 2Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Search for other works by this author on: This Site PubMed Google Scholar Nathaniel D. Krupp, M.D.; Nathaniel D. Krupp, M.D. 3Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Search for other works by this author on: This Site PubMed Google Scholar Thomas P. Sullivan, M.D. Thomas P. Sullivan, M.D. 4Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information Published online first on October 3, 2022. Address correspondence to Dr. Royster: Anesthesiology December 2022, Vol. 137, 733–734. https://doi.org/10.1097/ALN.0000000000004356 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Roger L. Royster, Sean D. Johnson, Nathaniel D. Krupp, Thomas P. Sullivan; Radiographic Demonstration of Hypoxic Pulmonary Vasoconstriction during One-lung Ventilation. Anesthesiology 2022; 137:733–734 doi: https://doi.org/10.1097/ALN.0000000000004356 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: hypoxic pulmonary vasoconstriction, one lung ventilation Hypoxic pulmonary vasoconstriction occurs when the microvasculature perfusing hypoxic alveoli vasoconstricts, diverting blood to oxygenated alveoli to match ventilation with perfusion.1 Hypoxic pulmonary vasoconstriction can occur within seconds and reach a maximum intensity within minutes of hypoxia developing. It appears to be triggered by a mitochondrial redox signal secondary to changes in molecular oxygen that activates voltage-gated potassium and calcium channels which results in vasoconstriction.2 One-lung ventilation can acutely cause global alveolar hypoxia and hypoxic pulmonary vasoconstriction in the nonventilated lung. It is estimated that blood flow to a nonventilated lung can be reduced by as much as 50% if the lung is without atelectasis.3 The pulmonary angiograms were performed in a patient with a history of hemoptysis in whom a computed tomography angiogram demonstrated a pulmonary pseudoaneurysm with a presumed bronchial fistula in the right lung. The patient was scheduled for embolization with interventional radiology under... You do not currently have access to this content.