[Differential artificial lung ventilation as an alternative to single lung ventilation in thoracic surgery]

The study was undertaken to develop and introduce a lung artificial ventilation (LAV) procedure that levels the pathophysiological changes associated with collapse of the lung operated on, which is based on comparison of the impact of one-lung and differential LAV on gas exchange and hemodynamics. It was found that under differential ventilation, ventilation-perfusion ratios became normal, pulmonary pressure dropped, resistance in all regions of the lung microcirculatory bed decreased, the volume of intrapulmonary shunting became smaller. Concomitantly, there were reductions in right cardiac preload and fluid filtration into the both parts of the extravascular lung space. This all shows that there is a significant increase in the efficiency of intrapulmonary gas exchange. Thus, differential ventilation is the most advisable alternative to collapse of the independent lung in thoracic surgery hemodynamics. It is the method of choice in pulmonary hypertension, right ventricular failure, oxygenation function of the lung.