ACUTE LIFE-THREATENING INTRAOPERATIVE ATELECTASIS

A case is presented of acute intraoperative atelectasis causing profou nd hypoxaemia in a patient undergoing a combined epidural-general anae sthetic for hip surgery in the lateral position. The pathophysiology o f the resultant ventilation-perfusion mismatch and the effects of appl ied positive end-expiratory pressure in the lateral position are explo red. The emergency management is assessed with emphasis on the role of bronchoscopy in diagnosis and treatment of this rare cause of life-th reatening hypoxaemia in the operating room. This patient with risk fac tors for respiratory complications may have benefited from preoperativ e bronchoscopy to assist in lung expansion.