Independent lung ventilation for asymmetrical chest trauma: effect on ventilatory and haemodynamic parameters

Complex thoracic injuries significantly alter the lung mechanics. There appears to be severe ventilation-perfusion inequality that is enhanced by the asymmetrical compliance of the injured areas. In cases of unilateral massive air leaks large tidal volumes are needed to deliver adequate air volume to the injured lung. In such cases, mechanical ventilation via a standard tracheal tube will direct a large fraction of the tidal volume to the less affected areas. An alternative means of ventilating these patients is the application of independent lung ventilation through a double lumen tracheal tube and the use of two separate ventilators. Two such cases are presented with emphasis given on the ventilatory and haemodynamic changes that were recorded.