Therapy of unilateral pulmonary insufficiency with a double lumen endotracheal tube

Successful therapy of unilateral acute lung disease has been infrequent. The marked compliance difference that exists between the acutely diseased and normal lung may make conventional respiratory therapy ineffective in treating the diseased lung. Vigorous attempts at reexpansion of the involved lung including bronchoscopy, continuous positive pressure ventilation, chest physiotherapy, suctioning, and position changes are usually successful in acute lung disease but were ineffective in the case presented. The use of the double lumen endotracheal tube, Carlens tube, and the application of differential ventilation was a safe and effective modality of therapy when conventional measures failed. The method of ventilation and the patient's course are described.