Clinical study on the treatment of severe asymmetric lung injury through differential lung ventilation
Abstract：Objective To discuss the effect of differential lung ventilation ( DLV) for treatment of severe asymmetric lung injury .Methods Fifteen cases of asymmetric lung injury leading to acute respiratory failure failed to conventional single -ventilation were selected , DLV started through two ventilators connected to bad ( serious damaged ) and good ( light or no damaged ) lung respectively after double lumen endotracheal intubation .Respiratory mechanics , hemodynamics and oxygenation index change were observed before ventilation and 12 h, 24 h and 36 h after ventilation .Results The related indicators were improved after DLV .Arterial oxygen saturation ( SaO2 ) increased after DLV , 24 h and 36 h value was significantly higher than previously (95 ±2, 97 ±2 vs 86 ±4, P<0.05).Oxygenation index (PaO2/FiO2 ) was improved, all time points were significantly higher than before (168 ±32, 253 ±41, 271 ±38 vs 126 ±29, P<0.05 or P<0.01), 24 h and 36 h value was significantly higher than 12 h (253 ±41, 271 ±38 vs 168 ±32, P <0.05).Pulmonary shunt (QS/QT) value was decreased, all time points were lower than before (16 ±4, 12 ±4, 10 ±3 vs 39 ±5, P<0.05).Mean arterial pressure (MAP) was improved, 24 h and 36 h value was higher than before (80 ±17, 85 ±18 vs 68 ±15, P<0.05).The bad lung pressure of end -tidal carbon dioxide (PETCO2) was significantly lower than that of good lung before DLV (10 ±3 vs 25 ±2, P<0.05), it increased significantly in 24 h and 36 h (18 ±4, 22 ±2 vs 10 ±3, P <0.05).The bad lung static lung compliance (Cst) was significantly lower than that of good lung before DLV (19.3 ±5.8 vs 42.6 ±6.7, P<0.05), three time points were significantly higher than before (32.1 ±6.3, 37.9 ±5.9, 41.5 ±6.7 vs 19.3 ±5.8, P<0.05), 36 h value was higher than 12 h (41.5 ±6.7 vs 32.1 ±6.3, P<0.05).The good lung dead space/tidal volume (VD/VT) ratio was significantly higher than that of bad lung before DLV (0.65 ± 0.12 vs 0.31 ±0.10, P<0.05), three time points were significantly lower than before (0.42 ±0.13, 0.36 ±0.11, 0.38 ±0.13 vs 0.65 ±0.12, P<0.05).The bad lung airway resistance (Raw) was significantly higher than that of good lung before DLV (25.7 ±2.2 vs 8.2 ±1.6, P<0.05), three time points were significantly lower than before (19.1 ±1.7, 10.6 ±2.0, 9.0 ±2.3 vs 25.7 ±2.2, P<0.05 or P<0.01), 24 h and 36 h value was lower than 12 h (10.6 ±2.0, 9.0 ±2.3 vs 19.1 ±1.7, P<0.05).Conclusion DLV may improve condition in patients diagnosed severe asymmetric lung injury failed to conventional single -ventilation.
Keywords：Differential lung ventilationAsymmetric lung injuryAcute respiratory failureDouble lumen endotracheal intubation
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 878-882 )