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A novel technique of differential lung ventilation in the critical care setting.

Yamakawa K, Nakamori Y, Fujimi S, Ogura H, Kuwagata Y, Shimazu T - BMC Res Notes (2011)

Bottom Line: Thus, long-term ventilatory management with this method may be associated with high risk of respiratory incidents in the critical care setting.The described technique was successfully performed in all five patients.This novel DLV technique appears to be efficacious and safe in the critical care setting.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka Suita, Osaka 565-0871, Japan. k.yamakawa0911@gmail.com.

ABSTRACT

Background: Differential lung ventilation (DLV) is used to salvage ventilatory support in severe unilateral lung disease in the critical care setting. However, DLV with a double-lumen tube is associated with serious complications such as tube displacement during ventilatory management. Thus, long-term ventilatory management with this method may be associated with high risk of respiratory incidents in the critical care setting.

Findings: We devised a novel DLV technique using two single-lumen tubes and applied it to five patients, two with severe unilateral pneumonia and three with thoracic trauma, in a critical care setting. In this novel technique, we perform the usual tracheotomy and insert two single-lumen tubes under bronchoscopic guidance into the main bronchus of each lung. We tie the two single-lumen tubes together and suture them directly to the skin. The described technique was successfully performed in all five patients. Pulmonary oxygenation improved rapidly after DLV induction in all cases, and the three patients with thoracic trauma were managed by DLV without undergoing surgery. Tube displacement was not observed during DLV management. No airway complications occured in either the acute or late phase regardless of the length of DLV management (range 2-23 days).

Conclusions: This novel DLV technique appears to be efficacious and safe in the critical care setting.

No MeSH data available.


Related in: MedlinePlus

Photographs showing our DLV technique. (a, b) Two single-lumen tubes are inserted into the tracheotomy site and are connected to two ventilator circuits respectively.
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Figure 2: Photographs showing our DLV technique. (a, b) Two single-lumen tubes are inserted into the tracheotomy site and are connected to two ventilator circuits respectively.

Mentions: Technique (illustrated in Figures 1 and 2)


A novel technique of differential lung ventilation in the critical care setting.

Yamakawa K, Nakamori Y, Fujimi S, Ogura H, Kuwagata Y, Shimazu T - BMC Res Notes (2011)

Photographs showing our DLV technique. (a, b) Two single-lumen tubes are inserted into the tracheotomy site and are connected to two ventilator circuits respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3101656&req=5

Figure 2: Photographs showing our DLV technique. (a, b) Two single-lumen tubes are inserted into the tracheotomy site and are connected to two ventilator circuits respectively.
Mentions: Technique (illustrated in Figures 1 and 2)

Bottom Line: Thus, long-term ventilatory management with this method may be associated with high risk of respiratory incidents in the critical care setting.The described technique was successfully performed in all five patients.This novel DLV technique appears to be efficacious and safe in the critical care setting.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka Suita, Osaka 565-0871, Japan. k.yamakawa0911@gmail.com.

ABSTRACT

Background: Differential lung ventilation (DLV) is used to salvage ventilatory support in severe unilateral lung disease in the critical care setting. However, DLV with a double-lumen tube is associated with serious complications such as tube displacement during ventilatory management. Thus, long-term ventilatory management with this method may be associated with high risk of respiratory incidents in the critical care setting.

Findings: We devised a novel DLV technique using two single-lumen tubes and applied it to five patients, two with severe unilateral pneumonia and three with thoracic trauma, in a critical care setting. In this novel technique, we perform the usual tracheotomy and insert two single-lumen tubes under bronchoscopic guidance into the main bronchus of each lung. We tie the two single-lumen tubes together and suture them directly to the skin. The described technique was successfully performed in all five patients. Pulmonary oxygenation improved rapidly after DLV induction in all cases, and the three patients with thoracic trauma were managed by DLV without undergoing surgery. Tube displacement was not observed during DLV management. No airway complications occured in either the acute or late phase regardless of the length of DLV management (range 2-23 days).

Conclusions: This novel DLV technique appears to be efficacious and safe in the critical care setting.

No MeSH data available.


Related in: MedlinePlus