[The indication for the use of an endobronchial double lumen tube in the intensive care of unilateral pulmonary complications].

Experiences gained in 5 patients subjected to endobronchial intubation with a double-lumen tube on account of several causes are reported. The mean length of application was 45.3 (6.5-67.5 h), and depending on the underlying diagnosis, several techniques of controlled ventilation or spontaneous breathing were used. In all cases arterial blood pressure and central venous pressure were continuously monitored throughout the duration of the treatment, and in some cases the airway pressures were measured. Frequent blood gas analyses were carried out and x-rays of the chest regularly taken. In one case the haemodynamic patterns were studied via a Swan-Ganz catheter. In all cases an improvement of the predominantly unilateral pathology of the lungs was observed under independent ventilation or spontaneous breathing, as assessed by blood gas analysis and of x-ray examination. Irrespective of synchronization, the simultaneous application of 2 ventilators for the controlled ventilation of the patient had clinically no relevant effects on haemodynamics. In cases of unilateral pulmonary complications we therefore see at present the following indications for using a double lumen endobronchial tube: 1. Therapy resistant resorption atelectasis, 2. interstitial or intraalveolar pulmonary edema, 3. therapy resistant pulmonary fistula, 4. pulmonary infiltrations and 5. pulmonary contusions with endobronchial bleeding. We believe that double lumen endobronchial plastic tubes with hi-lo cuffs are, when properly applied, an advance in long term intubation and mechanical ventilation managements.