[Intraoperative dual-mode independent lung ventilation for open-chest surgery: conventional volume-set ventilation in healthy lung and high frequency jet ventilation in diseased lung].

An effort by the anesthesiologist to maintain adequate ventilation during thoracic surgery is sometimes disturbing for the operative procedures of the surgeon. Unilateral ventilation with a large tidal volume, leaving the operative site unventilated, may provide an adequate and quiet operative field, but is opposed by the problem of disturbance in pulmonary gas exchange. The application of high frequency jet ventilation has recently been introduced to solve these problems. However, the disadvantage inherent to this technique is the tendency to produce carbon dioxide retention although it provides adequate oxygenation. In the present study, using a double lumen endobronchial tube, the large-tidal volume ventilation of the non-operative site and the high frequency jet ventilation with small tidal volume of the operative site were performed simultaneously. This technique provided the satisfactory condition of operative field, i.e., "quiet lung". Also, the serial gas analysis of the arterial and mixed venous blood samples indicated the satisfactory condition of pulmonary gas exchange.