Background Limited information is available regarding the application of lung-protective ventilation strategies during one-lung ventilation (OLV) across mainland China. A nationwide questionnaire survey was conducted to investigate this issue in current clinical practice. Methods The survey covered various aspects, including respondent demographics, the establishment and maintenance of OLV, intraoperative monitoring standards, and complications associated with OLV. Results Five hundred forty-three valid responses were collected from all provinces in mainland China. Volume control ventilation mode, 4 to 6 mL per kilogram of predictive body weight, pure oxygen inspiration, and a low-level positive end-expiratory pressure <= 5 cm H2O were the most popular ventilation parameters. The most common thresholds of intraoperative respiration monitoring were peripheral oxygen saturation (SpO(2)) of 90-94%, end-tidal CO2 of 45 to 55 mm Hg, and an airway pressure of 30 to 34 cm H2O. Recruitment maneuvers were traditionally performed by 94% of the respondents. Intraoperative hypoxemia and laryngeal injury were experienced by 75% and 51% of the respondents, respectively. The proportions of anesthesiologists who frequently experienced hypoxemia during OLV were 19%, 24%, and 7% for lung, cardiovascular, and esophageal surgeries, respectively. Up to 32% of respondents were reluctant to perform lung-protective ventilation strategies during OLV. Multiple regression analysis revealed that the volume-control ventilation mode and an SpO(2) intervention threshold of < 85% were independent risk factors for hypoxemia during OLV in lung and cardiovascular surgeries. In esophageal surgery, working in a tier 2 hospital and using traditional ventilation strategies were independent risk factors for hypoxemia during OLV. Subgroup analysis revealed no significant difference in intraoperative hypoxemia during OLV between respondents who performed lung-protective ventilation strategies and those who did not. Conclusions Lung-protective ventilation strategies during OLV have been widely accepted in mainland China and are strongly recommended for esophageal surgery, particularly in tier 2 hospitals. Implementing volume control ventilation mode and early management of oxygen desaturation might prevent hypoxemia during OLV.
[1]Fujian Med Univ, Union Hosp, Dept Cardiovasc Surg, Xinquan Rd 29, Fuzhou 350001, Fujian, Peoples R China.
[2]Fujian Med Univ, Dept Phys Examinat Ctr, Union Hosp, Xinquan Rd 29, Fuzhou 350001, Fujian, Peoples R China.
[3]Fujian Med Univ, Dept Crit Care Med, Union Hosp, 29 Xinquan Rd, Fuzhou 350001, Fujian, Peoples R China.
[4]Shandong First Med Univ, Shandong Prov Hosp, Dept Anesthesiol, Jinan, Peoples R China.
[5]First Peoples Hosp Yulin, Dept Anesthesiol, Yulin, Peoples R China.
[6]Hainan Med Univ, Hainan Gen Hosp, Dept Anesthesiol, Hainan Affiliated Hosp, Haikou, Peoples R China.
[7]Zhengzhou Univ, Affiliated Hosp 5, Dept Anesthesiol, Zhengzhou, Peoples R China.
[8]Third Peoples Hosp Henan Prov, Dept Anesthesia & Surg, Zhengzhou, Peoples R China.
[9]Binzhou Peoples Hosp, Dept Anesthesiol, Binzhou, Peoples R China.
[10]South Med Univ, Shunde Hosp, Dept Anesthesiol, Foshan 528300, Peoples R China.
[11]Capital Med Univ, Nanchong Hosp, Dept Neurosurg, Beijing Anzhen Hosp, Nanchong, Sichuan, Peoples R China.
[12]Wenzhou Med Univ, Dept Anesthesiol, Affiliated Hosp 1, Wenzhou, Peoples R China.
[13]Second Cent Hosp Baoding, Dept Orthoped, Baoding, Hebei, Peoples R China.
[14]Liaocheng Peoples Hosp, Dept Anesthesiol, Liaocheng, Peoples R China.
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