title: Independent lung ventilation in the management of ARDS and bronchopleural fistula.
abstract: Independent lung ventilation is a decades-old, but infrequently used technique for physiological separation in critically-ill patients with asymmetric lung disease. Here we present a case report of bilateral necrotizing pneumonia complicated by acute respiratory distress syndrome and bronchopleural fistula, which was successfully managed with independent lung ventilation. The use of independent lung ventilation allowed for adequate oxygenation with use of high positive end expiratory pressure in the "good lung" while simultaneously allowing for closure of the bronchopulmonary fistula in the contralateral lung by maintaining relatively low airway pressures.
authors.affiliation: Department of Medicine, Lahey Clinic, Burlington, MA, USA. Electronic address: jasmit.minhas@lahey.org.
authors.forename: Jasmit S
authors.initials: JS
authors.lastname: Minhas
authors.affiliation: Department of Medicine, Lahey Clinic, Burlington, MA, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Halligan
authors.affiliation: Department of Medicine, Lahey Clinic, Burlington, MA, USA; Division of Pulmonary and Critical Care, Department of Medicine, Lahey Clinic, Burlington, MA, USA; Tufts University School of Medicine, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Dargin
mesh_terms: D000368:Aged; D001983:Bronchial Fistula / Q000150:complications / Q000628:therapy*; D016638:Critical Illness; D005260:Female; D006801:Humans; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000628:therapy*
keywords: Acute respiratory distress syndrome; Bronchopleural fistula; Independent lung ventilation; Lung protective strategy; Necrotizing pneumonia; Pneumothorax