Effect of Apneic Oxygenation of the Non-ventilated Lung During Lung Cancer Surgery.

This study investigates the effect of apneic oxygenation of the non-ventilated lung on local and systemic inflammatory response during lung cancer surgery. Patients undergoing surgical resection of lung cancer often require one-lung ventilation during anaesthesia. This results in alveolar hypoxia accompanied by upregulated expression of inflammatory markers. Apneic oxygenation of the non-ventiladed lung may influence inflammatory processes and oxygenation during surgery. The aim of this study is to evaluate whether apneic oxygenation affects inflammatory markers in lung tissue and postoperative recovery in patients undergoing lung cancer surgery. The study is conducted at a single center and includes adult patients scheduled for elective lung cancer surgery. Data will be collected durig the perioperative period. The results of this study may contribute to improved anaesthetic management and patient outcomes during thoracic surgery.

Inclusion Criteria: * Adults aged 18 years or older * Patients scheduled to undergo surgical resection of a single lung segment for lung cancer * Written informed consent provided Exclusion Criteria: * Age younger than 18 years * Chronic corticosteroid therapy and/or other immunomodulatory treatments * Severe pulmonary diseases, including: Chronic obstructive pulmonary disease classified as GOLD stage 3-4 (Global Initiative for Chronic Obstructive Lung Disease). Severe asthma according to GINA classification (Global Initiative for Asthma), step 4. Severe interstitial lung disease defined by: Forced vital capacity (FVC) \< 50% predicted, diffusing capacity of the lung for carbon monoxide (DLCO) \< 40% predicted, presence of extensive pulmonary fibrosis on computed tomography (CT) * Surgical procedure expected to last less than 2 hours * Intraoperative hemodynamic instability, defined as: Mean arterial pressure \< 60 mmHg for more than 30 minutes despite adequate volume resuscitation, requirement for high-dose vasopressor support (norepinephrine \> 0.2 µg/kg/min) * New-onset intraoperative cardiac arrhythmias * Significant intraoperative blood loss, defined as the need for transfusion of more than two units of packed red blood cells * Intraoperative ventilatory instability, defined as: Severe hypoxemia (PaO₂ \< 60 mmHg or SpO₂ \< 85% with FiO₂ 1.0), hypercapnia (PaCO₂ \> 70 mmHg with pH \< 7.2), inability to achieve adequate ventilation.