| A Dual-Mode Asynchronous Independent Lung Ventilation. |
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Ryung Choi, Won Oak Kim, Dae Ja Um, Sae Whan Kim |
1Department of Anesthesiology, Wonju Medical College, Yonsei University, Korea.
2Department of Thoracic and Cardiovascular Surgery, Wonju Medical College, Yonsei University, Korea. |
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| Abstract |
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Differential independent lung ventilation is gaining growing attention for management of patients with unilateral pulmonary pathology. This case presents the method for the intraoperative anesthetic management of a patient with empyema and bronchopleural fistula of the left lung which could be controlled by the use of dual-mode asynchronous lung ventilation. The healthy right lung was ventilated by a conventional mechanical ventilator and disessde left lung by a high frequency jet ventilator. The use of endotracheal anesthesia and high frequency ventilation were necessary to prevent drainage of infected secretions into the right side healthy lung and to achieve good gas exchange in the presence of a bronchoplsural fistula. The method used by us, high frequency ventilation for the diseased lung a conventional mechanical ventilation for the other, demonstrated that differential independent lung ventilation using double lumen tube as in this case was suited for handling the problem of a bronchopleural fistula and empyema, further extending the indication for a giant lung bulls, lung cyst, major tracheobronchial disruption and one lung contaminating the other lung with either infected material or blood. |
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