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Independent lung ventilation: Implementation strategies and review of literature

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...

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Detalles Bibliográficos
Autores principales: Berg, Sheri, Bittner, Edward A, Berra, Lorenzo, Kacmarek, Robert M, Sonny, Abraham
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817931/
https://www.ncbi.nlm.nih.gov/pubmed/31667133
http://dx.doi.org/10.5492/wjccm.v8.i4.49
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author Berg, Sheri
Bittner, Edward A
Berra, Lorenzo
Kacmarek, Robert M
Sonny, Abraham
author_facet Berg, Sheri
Bittner, Edward A
Berra, Lorenzo
Kacmarek, Robert M
Sonny, Abraham
author_sort Berg, Sheri
collection PubMed
description 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.
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spelling pubmed-68179312019-10-30 Independent lung ventilation: Implementation strategies and review of literature Berg, Sheri Bittner, Edward A Berra, Lorenzo Kacmarek, Robert M Sonny, Abraham World J Crit Care Med Minireviews 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. Baishideng Publishing Group Inc 2019-07-31 /pmc/articles/PMC6817931/ /pubmed/31667133 http://dx.doi.org/10.5492/wjccm.v8.i4.49 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Minireviews
Berg, Sheri
Bittner, Edward A
Berra, Lorenzo
Kacmarek, Robert M
Sonny, Abraham
Independent lung ventilation: Implementation strategies and review of literature
title Independent lung ventilation: Implementation strategies and review of literature
title_full Independent lung ventilation: Implementation strategies and review of literature
title_fullStr Independent lung ventilation: Implementation strategies and review of literature
title_full_unstemmed Independent lung ventilation: Implementation strategies and review of literature
title_short Independent lung ventilation: Implementation strategies and review of literature
title_sort independent lung ventilation: implementation strategies and review of literature
topic Minireviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817931/
https://www.ncbi.nlm.nih.gov/pubmed/31667133
http://dx.doi.org/10.5492/wjccm.v8.i4.49
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