It is possible to live a functional life with only one lung, a procedure known as a pneumonectomy. The human body possesses abilities to compensate for the loss of a major organ, allowing many individuals to maintain a near-normal daily existence. The success of this adaptation is highly dependent on the health of the remaining lung and the individual’s overall physical condition prior to the operation. While the body can adjust to provide sufficient oxygen for everyday activities, a pneumonectomy fundamentally changes the mechanics of breathing and gas exchange.
Reasons for Removing a Lung
The removal of an entire lung is a major surgical intervention reserved for severe medical circumstances when no less-extensive procedure can resolve the problem. The most frequent reason for a pneumonectomy is to treat lung cancer that is widespread within the organ or is centrally located near the main airway, making a partial removal impossible. This procedure is typically considered only after careful assessment ensures the patient’s other lung is healthy enough to sustain life.
The surgery may also be required following traumatic lung injury where the damage is irreparable. Chronic, severe infections that have destroyed lung tissue are another common indication. These include advanced cases of pulmonary tuberculosis, extensive fungal infections, or severe bronchiectasis, where the airways are irreversibly damaged and widened. In extremely rare instances, a person may be born with only one lung.
How the Remaining Lung Adjusts
The remaining lung immediately begins a process of physiological compensation to take over the work of two lungs. The first and most significant adaptation is hyperinflation, where the single lung physically expands to fill the space left vacant in the chest cavity. This expansion increases the lung’s total volume and surface area for gas exchange, maximizing its capacity to absorb oxygen and expel carbon dioxide.
The space created by the removed lung is initially filled with air, which is gradually replaced by fluid that eventually gelatinizes into a proteinaceous material. Simultaneously, the diaphragm on the affected side elevates, and the mediastinum, which contains the heart and major blood vessels, shifts toward the empty space to stabilize the chest. This anatomical shift helps prevent the remaining lung from being overstretched.
The circulatory system also adapts, as the entire cardiac output must now be directed through the single lung. Pulmonary blood flow to the remaining organ effectively doubles to compensate for the loss of the other lung’s vascular bed. This increased perfusion, combined with the mechanical hyperinflation, allows the body to maintain normal arterial blood gas levels at rest.
Immediate Recovery and Rehabilitation
The initial recovery phase following a pneumonectomy is intensive, typically requiring a hospital stay of five to 14 days. Pain management often involves regional blocks to provide continuous, localized relief that facilitates deep breathing. Early mobilization, including walking on the first day after surgery, is encouraged to prevent complications and begin rebuilding strength.
A chest tube may be temporarily placed in the empty space, though it is not connected to suction, as this negative pressure can cause dangerous shifting of the heart and other structures. Respiratory therapy is a central component of rehabilitation, focusing on techniques like incentive spirometry and pursed-lip breathing. These exercises help ensure the remaining lung is fully inflated and functioning optimally while clearing any accumulated secretions.
Long-Term Lifestyle Considerations
Long-term life with one lung requires certain adjustments to safeguard the remaining organ. While patients can generally perform everyday tasks without issue, maximal exercise capacity is significantly reduced, and shortness of breath is common during intense physical exertion. Strenuous activities will be limited primarily by the cardiovascular system’s ability to process the increased blood flow.
The single lung is the sole respiratory reserve, making protection against illness essential. Individuals must be diligent about receiving annual influenza and pneumonia vaccinations to prevent serious respiratory infections. Any symptoms of a cold, flu, or chest infection should be addressed immediately by a healthcare provider.
Certain environmental and travel activities require caution or avoidance due to the reduced respiratory capacity. Scuba diving is strictly contraindicated because of the risks associated with pressure changes and gas expansion in the chest cavity. High-altitude travel, where oxygen concentration is naturally lower, may also be restricted or require supplemental oxygen. Smoking is forbidden, as the remaining lung cannot tolerate the damage caused by tobacco smoke.