COPD GOLD grades III and IV, lung fibrosis, documented bullae, severe emphysema, pneumothorax
uncontrolled asthma
Heart failure NYHA Grade 3 and 4, Coronary Heart Disease CCS Grade 3 and 4
previous lung surgery
documented pulmonary arterial hypertension >25mmHg MPAP at rest or > 40 mmHg syst. (estimated by ultrasound)
documented or suspected neuromuscular disease (thymoma, myasthenia, myopathies, muscular dystrophies, others)
planned mechanical ventilation after surgery
bilateral procedures
lung separation with other method than DLT (e.g. difficult airway, tracheostomy)
surgery in prone position
persistent hemodynamic instability, intractable shock
intracranial injury or tumor
enrollment in other interventional study or refusal of informed consent
pregnancy (excluded by anamnesis and/or laboratory analysis)
esophagectomy, pleural surgery only, sympathectomy surgery only, chest wall surgery only, mediastinal surgery only, lung transplantation
presence before induction of anaesthesia of one of the adverse events, listed as postoperative pulmonary complications (aspiration, moderate respiratory failure, infiltrates, pulmonary infection, atelectasis, cardiopulmonary edema, pleural effusion, pneumothorax, pulmonary embolism, purulent pleuritis, lung hemorrhage)
documented preoperative hypercapnia > 45mmHg (6kPa)