ISSN:
1432-1238
Keywords:
Differential lung ventilation
;
Differential carbondioxide production
;
Unilateral lung contusion
;
Monitoring
;
Polytrauma
;
Differential pulmonary perfusion
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Eighteen severely injured polytrauma patients (ISS 38±18) with severe asymmetric pulmonary contusion were ventilated with differential lung ventilation (DLV) to improve oxygenation and/or to prevent further unnecessary barotrauma to the lesser involved lung. Differential VCO2 was studied as a parameter for indirect measurement of effective individual pulmonary perfusion. One hour after starting DLV, difference in differential VCO2 (delta VCO2) was 81±57ml/min. In 16 patients this had fallen significantly (p〈0.001) to 32±30ml/min, 1 h before DLV was discontinued. In 2 patients, VCO2 remained 〉 than 200ml/min, coinciding with clinical deterioration and increasing consolidation of the pulmonary contusion. Bilobectomies were performed in both patients. The excised lobes appeared to be destroyed as the result of laceration, bleeding and subsequent haematomas. This clinical study supports laboratory studies suggesting the usefulness of monitoring differential VCO2 to assess effective differential pulmonary perfusion during DLV.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00257460
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