[Independent lung ventilation for asymmetric injury: case report as a demonstration of common challenge]

The article deals with a case of conventional mechanical ventilation in 75 y.o. woman with the background of uncompensated diabetes mellitus, suffering from bilateral pneumonia with predominantly left-sided lesion and severe sepsis. The conventional mechanical ventilation with high pressure levels led to arterial hypoxemia with P/F ratio 52. Independent lung ventilation immediately increased oxygenation up to P/F ratio 225 and evidently improved left lung aeration. The case demonstrates that while applying high pressures to open alveoli, we could not only provoke ventilator-induced lung injury and low cardiac output, but also "squeeze out" pulmonary perfusion from ventilated areas to non-ventilated ones with less intraalveolar pressure levels.