title: Independent lung ventilation for treatment of post-traumatic ARDS.
abstract: BACKGROUND
  Independent lung ventilation (ILV) has been recommended for unilateral pulmonary pathology. We describe a case of a multiple trauma patient treated with ILV for unilateral lung injury.
  
  
  METHODS
  Following a road accident, an 18 year-old male patient was referred to the university hospital with multiple organ failure, a ruptured liver and spleen, a fractured spine at the Th1-2 level, and left lung contusion. Splenectomy and liver repair had been performed in a regional hospital. On admission, a left sided pneumothorax and haemothorax were diagnosed and an emergency thoracotomy was performed, with partial resection of the left lower lobe. Because of the failure of recruitment of the left upper lobe, the patient was intubated with a double lumen tube and ILV was started using a single ventilator and a prototype flow separator, allowing separation of volume and PEEP settings. The left lung was ventilated with larger volumes and a higher PEEP than the right side, resulting in rapid improvement of gas exchange, reduction of air leak, and a return to conventional ventilation within two days. The patient underwent spinal stabilisation, and was extubated a few days later and transferred to a rehabilitation unit.
  
  
  CONCLUSIONS
  ILV with a larger tidal volume and high PEEP may be indicated in unilateral lung injury with a significant air leak from the injured tissue.
authors.affiliation: 1st Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin. ss@wp.pl
authors.forename: Sławomir
authors.initials: S
authors.lastname: Sawulski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Nestorowicz
authors.forename: Jarosław
authors.initials: J
authors.lastname: Wośko
authors.forename: Wojciech
authors.initials: W
authors.lastname: Dąbrowski
authors.forename: Michał
authors.initials: M
authors.lastname: Kowalczyk
authors.forename: Anna
authors.initials: A
authors.lastname: Fijałkowska
mesh_terms: D000293:Adolescent; D006801:Humans; D008297:Male; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D014947:Wounds and Injuries / Q000150:complications*