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Differential lung ventilation as an alternative to one‐lung ventilation during thoracotomy
Author(s) -
BARAKA A.
Publication year - 1994
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1994.tb04265.x
Subject(s) - medicine , ventilation (architecture) , lung , thoracotomy , ventilation perfusion mismatch , anesthesia , surgery , lung volumes , mechanical engineering , engineering
Summary Investigation was carried out on three elderly patients undergoing thoracotomy. During one‐lung ventilation using a Robertshaw double‐lumen tube, the PaO 2 decreased below 11·7 kPa despite ventilation of the dependent lung with 100% oxygen. Differential lung ventilation was then initiated by partial occlusion of the adapter limb to the nondependent lung, whilst maintaining unrestricted ventilation of the dependent lung. In the three patients, differential lung ventilation increased the PaO 2 to 15–37.2 kPa. The increased Pao 2 may be attributed to diffusion oxygenation via the partially inflated, nondependent lung. Differential lung ventilation can be used during thoracotomy whenever one‐lung ventilation is followed by hypoxaemia, despite adequate ventilation of the dependent lung with 100% oxygen.