open access

Vol 44, No 2 (2012 Apr-Jun)
Case reports
Published online: 2012-08-08
Submitted: 2012-07-05
Accepted: 2012-07-05
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Independent lung ventilation for treatment of post-traumatic ARDS

Sławomir Sawulski, Andrzej Nestorowicz, Jarosław Wośko, Wojciech Dąbrowski, Michał Kowalczyk, Anna Fijałkowska
Anaesthesiol Intensive Ther 2012;44(2):84-88.

open access

Vol 44, No 2 (2012 Apr-Jun)
Case reports
Published online: 2012-08-08
Submitted: 2012-07-05
Accepted: 2012-07-05

Abstract

BACKGROUND: Independent lung ventilation (ILV) has been recommended for unilateral pulmonary pathology. We describe a case of a multiple trauma patient treated with ILV for unilateral lung injury.

CASE REPORT: Following a road accident, an 18 year-old male patient was referred to the university hospital with multiple organ failure, a ruptured liver and spleen, a fractured spine at the Th1–2 level, and left lung contusion. Splenectomy and liver repair had been performed in a regional hospital. On admission, a left sided pneumothorax and haemothorax were diagnosed and an emergency thoracotomy was performed, with partial resection of the left lower lobe. Because of the failure of recruitment of the left upper lobe, the patient was intubated with a double lumen tube and ILV was started using a single ventilator and a prototype flow separator, allowing separation of volume and PEEP settings. The left lung was ventilated with larger volumes and a higher PEEP than the right side, resulting in rapid improvement of gas exchange, reduction of air leak, and a return to conventional ventilation within two days. The patient underwent spinal stabilisation, and was extubated a few days later and transferred to a rehabilitation unit.

CONCLUSIONS: ILV with a larger tidal volume and high PEEP may be indicated in unilateral lung injury with a significant air leak from the injured tissue.

Abstract

BACKGROUND: Independent lung ventilation (ILV) has been recommended for unilateral pulmonary pathology. We describe a case of a multiple trauma patient treated with ILV for unilateral lung injury.

CASE REPORT: Following a road accident, an 18 year-old male patient was referred to the university hospital with multiple organ failure, a ruptured liver and spleen, a fractured spine at the Th1–2 level, and left lung contusion. Splenectomy and liver repair had been performed in a regional hospital. On admission, a left sided pneumothorax and haemothorax were diagnosed and an emergency thoracotomy was performed, with partial resection of the left lower lobe. Because of the failure of recruitment of the left upper lobe, the patient was intubated with a double lumen tube and ILV was started using a single ventilator and a prototype flow separator, allowing separation of volume and PEEP settings. The left lung was ventilated with larger volumes and a higher PEEP than the right side, resulting in rapid improvement of gas exchange, reduction of air leak, and a return to conventional ventilation within two days. The patient underwent spinal stabilisation, and was extubated a few days later and transferred to a rehabilitation unit.

CONCLUSIONS: ILV with a larger tidal volume and high PEEP may be indicated in unilateral lung injury with a significant air leak from the injured tissue.

Get Citation

Keywords

Independent lung

About this article
Title

Independent lung ventilation for treatment of post-traumatic ARDS

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 44, No 2 (2012 Apr-Jun)

Pages

84-88

Published online

2012-08-08

Bibliographic record

Anaesthesiol Intensive Ther 2012;44(2):84-88.

Keywords

Independent lung

Authors

Sławomir Sawulski
Andrzej Nestorowicz
Jarosław Wośko
Wojciech Dąbrowski
Michał Kowalczyk
Anna Fijałkowska

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