Independent lung ventilation in a newborn with asymmetric acute lung injury due to respiratory syncytial virus

A case report

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Independent lung ventilation is a form of protective ventilation strategy used in adult asymmetric acute lung injury, where the application of conventional mechanical ventilation can produce ventilator-induced lung injury and ventilation-perfusion mismatch. Only a few experiences have been published on the use of independent lung ventilation in newborn patients. Case presentation: We present a case of independent lung ventilation in a 16-day-old infant of 3.5 kg body weight who had an asymmetric lung injury due to respiratory syncytial virus bronchiolitis. We used independent lung ventilation applying conventional protective pressure controlled ventilation to the less-compromised lung, with a respiratory frequency proportional to the age of the patient, and a pressure controlled high-frequency ventilation to the atelectatic lung. This was done because a single tube conventional ventilation protective strategy would have exposed the less-compromised lung to a high mean airways pressure. The target of independent lung ventilation is to provide adequate gas exchange at a safe mean airways pressure level and to expand the atelectatic lung. Independent lung ventilation was accomplished for 24 hours. Daily chest radiograph and gas exchange were used to evaluate the efficacy of independent lung ventilation. Extubation was performed after 48 hours of conventional single-tube mechanical ventilation following independent lung ventilation. Conclusion: This case report demonstrates the feasibility of independent lung ventilation with two separate tubes in neonates as a treatment of an asymmetric acute lung injury.

Original languageEnglish
Article number212
JournalJournal of Medical Case Reports
Volume2
DOIs
Publication statusPublished - Jun 19 2008

Fingerprint

Respiratory Syncytial Viruses
Acute Lung Injury
Ventilation
Newborn Infant
Lung
Pressure
Artificial Respiration
Gases
Ventilator-Induced Lung Injury
High-Frequency Ventilation
Bronchiolitis
Lung Injury
Thorax
Perfusion

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{23070e06cabf46e38a7f0a54e1084a11,
title = "Independent lung ventilation in a newborn with asymmetric acute lung injury due to respiratory syncytial virus: A case report",
abstract = "Introduction: Independent lung ventilation is a form of protective ventilation strategy used in adult asymmetric acute lung injury, where the application of conventional mechanical ventilation can produce ventilator-induced lung injury and ventilation-perfusion mismatch. Only a few experiences have been published on the use of independent lung ventilation in newborn patients. Case presentation: We present a case of independent lung ventilation in a 16-day-old infant of 3.5 kg body weight who had an asymmetric lung injury due to respiratory syncytial virus bronchiolitis. We used independent lung ventilation applying conventional protective pressure controlled ventilation to the less-compromised lung, with a respiratory frequency proportional to the age of the patient, and a pressure controlled high-frequency ventilation to the atelectatic lung. This was done because a single tube conventional ventilation protective strategy would have exposed the less-compromised lung to a high mean airways pressure. The target of independent lung ventilation is to provide adequate gas exchange at a safe mean airways pressure level and to expand the atelectatic lung. Independent lung ventilation was accomplished for 24 hours. Daily chest radiograph and gas exchange were used to evaluate the efficacy of independent lung ventilation. Extubation was performed after 48 hours of conventional single-tube mechanical ventilation following independent lung ventilation. Conclusion: This case report demonstrates the feasibility of independent lung ventilation with two separate tubes in neonates as a treatment of an asymmetric acute lung injury.",
author = "{Di Nardo}, Matteo and Daniela Perrotta and Francesca Stoppa and Corrado Cecchetti and Marco Marano and Nicola Pirozzi",
year = "2008",
month = "6",
day = "19",
doi = "10.1186/1752-1947-2-212",
language = "English",
volume = "2",
journal = "Journal of Medical Case Reports",
issn = "1752-1947",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Independent lung ventilation in a newborn with asymmetric acute lung injury due to respiratory syncytial virus

T2 - A case report

AU - Di Nardo, Matteo

AU - Perrotta, Daniela

AU - Stoppa, Francesca

AU - Cecchetti, Corrado

AU - Marano, Marco

AU - Pirozzi, Nicola

PY - 2008/6/19

Y1 - 2008/6/19

N2 - Introduction: Independent lung ventilation is a form of protective ventilation strategy used in adult asymmetric acute lung injury, where the application of conventional mechanical ventilation can produce ventilator-induced lung injury and ventilation-perfusion mismatch. Only a few experiences have been published on the use of independent lung ventilation in newborn patients. Case presentation: We present a case of independent lung ventilation in a 16-day-old infant of 3.5 kg body weight who had an asymmetric lung injury due to respiratory syncytial virus bronchiolitis. We used independent lung ventilation applying conventional protective pressure controlled ventilation to the less-compromised lung, with a respiratory frequency proportional to the age of the patient, and a pressure controlled high-frequency ventilation to the atelectatic lung. This was done because a single tube conventional ventilation protective strategy would have exposed the less-compromised lung to a high mean airways pressure. The target of independent lung ventilation is to provide adequate gas exchange at a safe mean airways pressure level and to expand the atelectatic lung. Independent lung ventilation was accomplished for 24 hours. Daily chest radiograph and gas exchange were used to evaluate the efficacy of independent lung ventilation. Extubation was performed after 48 hours of conventional single-tube mechanical ventilation following independent lung ventilation. Conclusion: This case report demonstrates the feasibility of independent lung ventilation with two separate tubes in neonates as a treatment of an asymmetric acute lung injury.

AB - Introduction: Independent lung ventilation is a form of protective ventilation strategy used in adult asymmetric acute lung injury, where the application of conventional mechanical ventilation can produce ventilator-induced lung injury and ventilation-perfusion mismatch. Only a few experiences have been published on the use of independent lung ventilation in newborn patients. Case presentation: We present a case of independent lung ventilation in a 16-day-old infant of 3.5 kg body weight who had an asymmetric lung injury due to respiratory syncytial virus bronchiolitis. We used independent lung ventilation applying conventional protective pressure controlled ventilation to the less-compromised lung, with a respiratory frequency proportional to the age of the patient, and a pressure controlled high-frequency ventilation to the atelectatic lung. This was done because a single tube conventional ventilation protective strategy would have exposed the less-compromised lung to a high mean airways pressure. The target of independent lung ventilation is to provide adequate gas exchange at a safe mean airways pressure level and to expand the atelectatic lung. Independent lung ventilation was accomplished for 24 hours. Daily chest radiograph and gas exchange were used to evaluate the efficacy of independent lung ventilation. Extubation was performed after 48 hours of conventional single-tube mechanical ventilation following independent lung ventilation. Conclusion: This case report demonstrates the feasibility of independent lung ventilation with two separate tubes in neonates as a treatment of an asymmetric acute lung injury.

UR - http://www.scopus.com/inward/record.url?scp=47349114116&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=47349114116&partnerID=8YFLogxK

U2 - 10.1186/1752-1947-2-212

DO - 10.1186/1752-1947-2-212

M3 - Article

VL - 2

JO - Journal of Medical Case Reports

JF - Journal of Medical Case Reports

SN - 1752-1947

M1 - 212

ER -