Crimi G, Candiani A, Conti G, Mattia C, Gasparetto A
Intensive Care Med. 1986;12(2):90-4. doi: 10.1007/BF00254518.
Six patients with unilateral acute lung injury (ALI) were treated with a new form of ventilatory support: independent lung ventilation with unilateral high-frequency jet ventilation (ILV-UHFJV). The first three patients suffered from unilateral ALI complicated by a bronchopleural fistula (BPF); they were at first ventilated with HFJV, but remained unresponsive to treatment, showing a progressive impairment of the ventilation/perfusion ratio with a deterioration in clinical condition. After selective bronchial intubation, ILV-UHFJV was started, ventilating the healthy lung with CPPV and the contralateral with HFJV. ILV-UHFJV caused a significant improvement in alveolar gas exchange leading to a rapid fall in Qs/Qt; it was also associated with a stable haemodynamic condition throughout the duration of the treatment. Subsequently, three more patients were treated; their respiratory failure was due to a unilateral ALI without BPF, unresponsive to either HFJV or CPPV. Once again, ILV-UHFJV was followed by a dramatic improvement in respiratory function; the haemodynamics remained unchanged and it was also possible to demonstrate a rapid improvement in individual and overall lung function.
6例单侧急性肺损伤（ALI）患者接受了一种新型通气支持治疗：单侧高频喷射通气独立肺通气（ILV-UHFJV）。前3例患者患有单侧ALI并伴有支气管胸膜瘘（BPF）；他们起初接受高频喷射通气治疗，但对治疗无反应，通气/灌注比逐渐受损，临床状况恶化。在选择性支气管插管后，开始进行ILV-UHFJV，用持续气道正压通气（CPPV）对健侧肺进行通气，对患侧肺用高频喷射通气。ILV-UHFJV使肺泡气体交换显著改善，导致Qs/Qt迅速下降；在整个治疗期间，它还与稳定的血流动力学状况相关。随后，又有3例患者接受治疗；他们的呼吸衰竭是由无BPF的单侧ALI引起的，对高频喷射通气或持续气道正压通气均无反应。同样，ILV-UHFJV之后呼吸功能有显著改善；血流动力学保持不变，还能够证明个体和整体肺功能迅速改善。
