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Funktionelle Trennung der Lungen

Beatmungsstrategie bei einseitigem stumpfem Thoraxtrauma

Functional separation of the lungs

Ventilation strategy for unilateral blunt force thoracic trauma

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Zusammenfassung

Ein Patient mit schwerer Hypoxämie [Horovitz-Quotient (paO2/FIO2) 61 mmHg], die infolge eines einseitigen stumpfen Thoraxtraumas und konsekutiver Lobärpneumonie auftrat, wurde seitengetrennt beatmet. Die funktionelle Trennung der Lungen ermöglichte ein Recruitment und „Ruhigstellen“ der konsolidierten Lunge [Atemwegsmitteldruck (pmean) 28 mbar, Atemfrequenz 4/min] sowie eine suffiziente Ventilation über die gesunde, konventionell beatmete Lunge (pmean 14 mbar). Mit dieser Beatmungsstrategie konnten eine stabile Oxygenierung sowie Ventilation erreicht und beatmungsinduzierten Lungenschäden vorgebeugt werden.

Abstract

Independent lung ventilation was performed in a patient with severe hypoxemia (oxygenation ratio paO2/FIO2 61 mmHg) due to unilateral blunt chest trauma and consecutive consolidation of the injured lung. Recruitment and immobilization of the consolidated lung was achieved by functional separation of both lungs with application of a mean airway pressure (pmean) of 28 mbar in combination with low frequency ventilation (4/min) of the injured lung. Adequate ventilation was maintained via the normal lung (pmean 14 mbar). This ventilation strategy stabilized oxygenation and ventilation by preventing overinflation and ventilator-induced lung injury.

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Correspondence to G. Hammersen.

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Hammersen, G., Beiderlinden, M. Funktionelle Trennung der Lungen. Anaesthesist 61, 1045–1048 (2012). https://doi.org/10.1007/s00101-012-2104-3

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  • DOI: https://doi.org/10.1007/s00101-012-2104-3

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