[Unilateral lung edema following chest injury: an indication for independent artificial respiration]

The successful treatment of a unilateral penetrating stab wound injury of the chest is reported. Following emergency resection of the upper and middle lobe of the right lung acute pulmonary oedema developed in the dependent left lung. Air-tight suture of an additional injury of the right lower lobe was not possible. To avoid formation of a fistula in the right lung, the patient was intubated with a double lumen endobronchial tube and both lungs were ventilated independently. Application of positive-endexspiratory pressure to the oedematous lung improved oxygenation without exposing the right lung to undue inspiratory pressure. The advantages and indications of a double-lumen endobronchial tube in the primary care of unilateral chest injuries are discussed.