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Selective right-lung ventilation during emergency department thoracotomy
1Division of Cardiovascular and Thoracic Surgery. University of Western Ontario, London, Canada.
Critical Care Medicine
|October 1, 1989
Summary
Surgeons can now expedite emergency cardiac repair using selective right-lung ventilation. This technique, tested in cadaver and animal models, ensures adequate oxygenation during emergency thoracotomies.
Area of Science:
- Emergency Medicine
- Thoracic Surgery
- Anesthesiology
Background:
- Penetrating cardiac injuries often present patients in extremis to the emergency department (ED).
- Immediate thoracotomy in the ED can yield good resuscitative outcomes for select patients.
- Left lung inflation during resuscitation frequently impedes effective cardiorrhaphy.
Purpose of the Study:
- To investigate a novel technique for selective right-lung ventilation.
- To assess the feasibility and efficacy of this technique in expediting emergency cardiac repair.
Main Methods:
- A technique for selective right-lung ventilation was developed using a standard single-lumen endotracheal tube.
- The technique was evaluated in cadaver and animal models.
Main Results:
- The selective right-lung ventilation technique was found to be easily applicable.
- Adequate oxygenation and ventilation were maintained for up to 60 minutes.
- The technique effectively expedited cardiorrhaphy in the simulated emergency department setting.
Conclusions:
- Selective right-lung ventilation is a practical approach for managing patients with penetrating cardiac injuries.
- This method facilitates timely cardiorrhaphy during emergency thoracotomies.
- The technique offers a valuable adjunct for improving outcomes in critical cardiac injury cases.