Clinical applications of independent lung ventilation with unilateral high-frequency jet ventilation (ILV-UHFJV).
Six patients with unilateral acute lung injury (ALI) were treated with a new form of ventilatory support: independent lung ventilation with unilateral high-frequency jet ventilation (ILV-UHFJV). The first three patients suffered from unilateral ALI complicated by a bronchopleural fistula (BPF); they were at first ventilated with HFJV, but remained unresponsive to treatment, showing a progressive impairment of the ventilation/perfusion ratio with a deterioration in clinical condition. After selective bronchial intubation, ILV-UHFJV was started, ventilating the healthy lung with CPPV and the contralateral with HFJV. ILV-UHFJV caused a significant improvement in alveolar gas exchange leading to a rapid fall in Qs/Qt; it was also associated with a stable haemodynamic condition throughout the duration of the treatment. Subsequently, three more patients were treated; their respiratory failure was due to a unilateral ALI without BPF, unresponsive to either HFJV or CPPV. Once again, ILV-UHFJV was followed by a dramatic improvement in respiratory function; the haemodynamics remained unchanged and it was also possible to demonstrate a rapid improvement in individual and overall lung function.
D000328:Adult; D000368:Aged; D001983:Bronchial Fistula / Q000628:therapy; D005260:Female; D005402:Fistula / Q000628:therapy; D006801:Humans; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000628:therapy; D011175:Positive-Pressure Respiration; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial / Q000379:methods*; D014692:Ventilation-Perfusion Ratio