Open AccessIndependent lung ventilation: Implementation strategies and review of literature
Author(s) -
Sheri Berg,
Edward A. Bittner,
Lorenzo Berra,
Robert M. Kacmarek,
Abraham Sonny
Publication year - 2019
Publication title -
world journal of critical care medicine
Language(s) - English
Resource type - Journals
ISSN - 2220-3141
DOI - 10.5492/wjccm.v8.i4.49
Subject(s) - medicine , ventilation (architecture) , lung , tidal volume , intensive care medicine , respiratory failure , mechanical ventilation , lung volumes , respiratory physiology , distension , pulmonary compliance , respiratory system , lung ventilation , anesthesia , cardiology , mechanical engineering , engineering
Independent lung ventilation, though infrequently used in the critical care setting, has been reported as a rescue strategy for patients in respiratory failure resulting from severe unilateral lung pathology. This involves isolating and ventilating the right and left lung differently, using separate ventilators. Here, we describe our experience with independent lung ventilation in a patient with unilateral diffuse alveolar hemorrhage, who presented with severe hypoxemic respiratory failure despite maximal ventilatory support. Conventional ventilation in this scenario leads to preferential distribution of tidal volume to the non-diseased lung causing over distension and inadvertent volume trauma. Since each lung has a different compliance and respiratory mechanics, instituting separate ventilation strategies to each lung could potentially minimize lung injury. Based on review of literature, we provide a detailed description of indications and procedures for establishing independent lung ventilation, and also provide an algorithm for management and weaning a patient from independent lung ventilation.