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Summary A young man with severe unilateral bronchiectasis and a ventricular septal defect presented for pneumonectomy. Intra-operative monitoring, which included continuous measurement of systemic and pulmonary oxygen saturations by oximetry, revealed transient reversal of the intracardiac shunt across the defect. The implications of this combination of cardiac and pulmonary disease for anaesthetic management are discussed.

Summary A case is reported in which percutaneous lung biopsy was followed by haemorrhage into the tracheobronchial tree. Hypoxia followed, precipitating a cardiac arrest. The haemorrhage was isolated by the insertion of a double-lumen tube. Complications arising from this method of biopsy are reviewed and the measures necessary to control the potentially fatal problems are discussed.