skip to main content

Asbestos Lung OLV Risk — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCardiothoracic AnaesthesiaAsbestos Lung OLV RiskFRCA Final

A 65-year-old man (ASA III) with known asbestos exposure presents for lung biopsy. CXR shows pleural plaques and a left pleural mass. He is scheduled for VATS biopsy. Which specific complication is he at increased risk for during one-lung ventilation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Suxamethonium apnoea

Asbestos-related pleural disease causes restrictive lung pathology with reduced compliance, reduced FRC, and impaired gas exchange. During one-lung ventilation, the already compromised ventilated lung has limited capacity to maintain oxygenation. Combined with the V/Q mismatch of OLV, these patients are at significantly higher risk of intraoperative hypoxia. Lung-protective ventilation, optimal PEEP, and recruitment manoeuvres are essential. CPAP to the non-ventilated lung and early identification of hypoxia with a low threshold for two-lung ventilation are important.

Reference: RCOA – 2023 – Cardiothoracic anaesthesia; BTS – 2018 – Mesothelioma guidelines