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Volume 16
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10.3390/life16071057
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Article

Preoperative Inflammatory Ratios and Severe Intraoperative Hypoxemia During One-Lung Ventilation: A Prospective Observational Study

by
Irina Saplacan
1,
Stefania Raluca Fodor
2,*,
Bianca Liana Grigorescu
2,
Manuela Rozalia Gabor
1,3,
Oana Coman
2,
Claudiu Puiac
2 and
Leonard Azamfirei
2
1
Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
2
Department of Anesthesiology and Intensive Care Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540103 Târgu Mureș, Romania
3
Department of Economic Sciences (ED1), Faculty of Economics and Law, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
*
Author to whom correspondence should be addressed.
Life 2026, 16(7), 1057; https://doi.org/10.3390/life16071057
Submission received: 2 June 2026 / Revised: 19 June 2026 / Accepted: 23 June 2026 / Published: 25 June 2026
(This article belongs to the Special Issue Innovations in Thoracic Medicine: Advancements and Challenges—2nd Edition)
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Abstract

(1) Background: One-lung ventilation (OLV) is frequently required during thoracic surgery, but hypoxemia remains a common intraoperative complication. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have emerged as inexpensive inflammatory biomarkers, although their role in predicting hypoxemia during OLV remains unclear. This study evaluated the association between preoperative NLR, PLR, and severe intraoperative hypoxemia during OLV. (2) This interim analysis included 103 patients undergoing elective thoracic surgery with OLV in a prospective observational cohort. Severe hypoxemia was defined as PaO2/FiO2 < 100. Group comparisons were performed using Mann–Whitney U and chi-square/Fisher’s exact tests. Hierarchical logistic regression and ROC analysis were used to evaluate predictors and model performance. (3) Results: Preoperative PLR significantly improved the predictive performance of the clinical model for severe intraoperative hypoxemia, while NLR was not associated with the outcome. BMI remained an independent predictor of hypoxemia. (4) Conclusions: PLR improved the predictive performance of the clinical model, although its inverse association with hypoxemia should be interpreted cautiously. NLR was not associated with hypoxemia during OLV.
Keywords: one-lung ventilation; hypoxemia; thoracic surgery; inflammatory markers one-lung ventilation; hypoxemia; thoracic surgery; inflammatory markers

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MDPI and ACS Style

Saplacan, I.; Fodor, S.R.; Grigorescu, B.L.; Gabor, M.R.; Coman, O.; Puiac, C.; Azamfirei, L. Preoperative Inflammatory Ratios and Severe Intraoperative Hypoxemia During One-Lung Ventilation: A Prospective Observational Study. Life 2026, 16, 1057. https://doi.org/10.3390/life16071057

AMA Style

Saplacan I, Fodor SR, Grigorescu BL, Gabor MR, Coman O, Puiac C, Azamfirei L. Preoperative Inflammatory Ratios and Severe Intraoperative Hypoxemia During One-Lung Ventilation: A Prospective Observational Study. Life. 2026; 16(7):1057. https://doi.org/10.3390/life16071057

Chicago/Turabian Style

Saplacan, Irina, Stefania Raluca Fodor, Bianca Liana Grigorescu, Manuela Rozalia Gabor, Oana Coman, Claudiu Puiac, and Leonard Azamfirei. 2026. "Preoperative Inflammatory Ratios and Severe Intraoperative Hypoxemia During One-Lung Ventilation: A Prospective Observational Study" Life 16, no. 7: 1057. https://doi.org/10.3390/life16071057

APA Style

Saplacan, I., Fodor, S. R., Grigorescu, B. L., Gabor, M. R., Coman, O., Puiac, C., & Azamfirei, L. (2026). Preoperative Inflammatory Ratios and Severe Intraoperative Hypoxemia During One-Lung Ventilation: A Prospective Observational Study. Life, 16(7), 1057. https://doi.org/10.3390/life16071057

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