Reply from the authors

Abstract

Editor'We thank Dr Russell for his interest in our editorial.1Ng A Swanevelder J Hypoxaemia associated with one-lung anaesthesia: new discoveries in ventilation and perfusion.Br J Anaesth. 2011; 106: 761-763doi:10.1093/bja/aer113Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar He cites an observational study of 10 patients, conducted in his department.2Russell WJ Intermittent positive airway pressure to manage hypoxia during one-lung anaesthesia.Anaesth Intensive Care. 2009; 37: 432-434PubMed Google Scholar Hypoxaemia during one-lung ventilation was attenuated by slow inflation of 2 litre min−1 of oxygen into the non-ventilated lung for 2 s, every 10 s, for a duration of 5 min or until oxygen saturation increased to 98%.2Russell WJ Intermittent positive airway pressure to manage hypoxia during one-lung anaesthesia.Anaesth Intensive Care. 2009; 37: 432-434PubMed Google Scholar Unfortunately, we did not cite Dr Russell's interesting study, owing to the restrictions of the peer-review process and the maximum number of references for editorials. In addition, the aforementioned study was perhaps an exploratory one as there were no data on the percentage of intrapulmonary shunt and no comparison with a similar technique involving administration of oxygen under continuous positive airway pressure, to the non-ventilated lung.3Ng A Swanevelder J Hypoxaemia during one-lung anaesthesia.Contin Educ Anaesth Crit Care Pain. 2010; 10: 117-122doi:10.1093/bjaceaccp/mkq019Abstract Full Text Full Text PDF Scopus (21) Google Scholar Hypoxaemia associated with one-lung ventilation is an important consideration for thoracic anaesthetists and we await further studies to confirm the utility of intermittent positive airway pressure. None declared. Hypoxaemia associated with one-lung anaesthesia: an alternative approachBritish Journal of AnaesthesiaVol. 107Issue 5PreviewEditor'Ng and Swanevelder examine the serious problem of hypoxaemia during one-lung anaesthesia and the factors which may exacerbate the hypoxaemia.1 They consider the ways it may be attenuated. However, they omit to consider boosting the oxygen content in the shunt. This can be achieved by a small amount of oxygen into the non-ventilated lung. This technique was described in 2009 and is referred to as IPAP (intermittent positive airway pressure).2 Small slow puffs of oxygen into the non-ventilated lung usually will quickly restore the arterial oxygen saturation above 95%. Full-Text PDF Open Archive