TITLE:
Intraoperative Hypotension in Thoracic Surgery: Limits to the Transportability of Evidence from Non-Thoracic Surgery
AUTHORS:
Sen Wang, Shiyan Zhao, Wanrong Huang, Benxin Zhu, Fuquan Zhu, Jialing Liao, Jiapeng Dan
KEYWORDS:
Intraoperative Hypotension, Thoracic Surgery, One-Lung Ventilation, Right Ventricular Function, Pulmonary Vascular Resistance, Vasopressors, Fluid Therapy, Lung Resection
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.17 No.10,
September
30,
2026
ABSTRACT: Hypotension during non-cardiac surgery is associated with myocardial injury, acute kidney injury, cerebral infarction and death; therefore, different mean arterial pressure thresholds have been set for various surgeries. We will determine why the results and treatment plans of thoracic surgery cannot be applied to other diseases of the chest easily, especially in cases of one-lung ventilation (OLV). Thoracic anaesthesia is a type of intrapulmonary shunt that causes hypoxic pulmonary vasoconstriction (HPV) and redistribution of pulmonary blood flow. Lateral positioning, conditions of the thoracic chamber and lung artery obstruction all increase the afterload of the right ventricle (RV), and the time to administer fluid is short. The mean arterial pressure should be less than 60 - 65 mmHg; if it is still this low or even lower, further investigation and treatment will be necessary. Monitor blood pressure, right ventricular (RV) function, pulmonary vascular resistance (PVR), oxygenation, airway pressure, haemorrhage and fluid responsiveness. Although the non-thoracic data have biological significance, random studies in the chest should be carried out before setting general blood pressure goals or haemodynamic models.