Ventilation during lung separation procedures
Enough working space for the surgeon is of utmost importance to enable an adequate surgical performance. Lung isolation techniques have been developed to increase this crucial working space by deflating one of the lungs and ventilating the other one.
A major drawback of ventilating one lung is the increased risk of hypoxemia (i.e. arterial oxygenation <90%), which may develop due to ventilation-perfusion mismatch and dissociation of O2 from hemoglobin (Bohr effect).
Oxygenation of the deflated non-dependent lung might be required in this case, using continuous positive airway pressure (CPAP). However, this is not always sufficient and can result in an undesired re-inflation of the lung.
This scenario can be prevented using the working principle of Ventrain, which now enables full ventilation of the non-dependent lung without re-inflation of the other e.g. a bronchial blocker.
Technology for ventilation of the
With the technology of Ventrain it is now possible to fully ventilate the non-dependent lung. Its assisted expiration capacities enable effective additional ventilation in order to prevent or rapidly overcome cases of hypoxemia.
Additionally, the non-dependent lung remains collapsed during ventilation, which means no delay or postponement of surgery. This ventilation technology also improves collapse initiation, ultimately resulting in a more effective collapse.
Advantages of expiration by suction during lung isolation techniques:
• Full ventilation (oxygenation and active CO2 removal);
• No reinflation of the non-dependent lung;
• Minimally invasive insertion (e.g. ID 1.6 mm);
• Selective blockage of specific lobe possible;
• Lung collapse time drastically shortened;
• Good mobilization of mucus.
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Dr. Johannes Schmidt, Department of Anesthesiology and Critical Care Medical Center, University of Freiburg, Germany, has won the Best Abstract Prize Competition during Euroanaesthesia, with ‘Expiratory Ventilation Assistance during mandatory ventilation in porcine...