Bilateral Vents

I was reading in the post on staffing ratios - that a hospital used a 2 lumen ETT and bilateral vents. Can anyone tell me why a person would need 2 vents? Or any information what would call for 2 vents on 1 patient. Just got my curiosity up. Thanks in advance.

Walter RN

[Geeg]

I took care of a cystic fibrosis patient s/p lung transplant. He was intubated with a double lumen tube, and separate vents for each one. This was necessary since the difference in the compliance of the transplanted and native CF lung necessitated much different vent settings.

[CCU NRS]

Thanks always love to learn new things. That is pretty cool I get it

[zambezi, BSN, RN]

Do they use double lumen tubes if there is a pulmonary artery rupture? It seems like I have heard this, thankfully haven't had to go down this road, close though. Any info?

[kc ccurn]

I seem to remember that years ago we used double lumen ETT and two vents for a trauma patient that sustained bad lung injury (I think he was stomped on the chest by a bull-OUCH) I think he had a pulmonary artery rupture but it's been too long ago now!

[renerian, BSN, RN]

Had no clue. Thanks for bringing up this thread.

renerian:D

[javajunkie]

I have only used a bifurcated ETT once on a patient with a unilateral lung injury. In this case, we only ventilated one side of the lungs. I was told, that we could ventilate the other lung if we needed to, but we would need another vent in order to give a different tidal volume and pressure to the injured lung. Luckily, that never happened, that would have been quite a crowd :)

[TraumaNurse]

I have also used bifurcated ETT with 2 vents on pt with lung ca and fibrosis mainly affecting 1 lung. Since she had near normal compliance in 1 lung and next to none in the other, we were better able to ventilate each side independently and reduce the barotrauma to the good lung.

[merlin100]

Do they use double lumen tubes if there is a pulmonary artery rupture? It seems like I have heard this, thankfully haven't had to go down this road, close though. Any info?

Hi, i'm fairly new on here, so please excuse any errors. I work in Cardiac ITU, and, yes, you would use a double lumen tube for PA rupture, (someything like a Robertshaws for example). But in my setting, PA rupture would most likely occur from use of PA catheters, or as an aftermath of surgery. The resultant sequale would be catestrophic, and you would be lucky to intubate in time. Hope this helps.

[heart queen]

okay, peaked my interest. I have read the mention of bifurcated and double lumen ETT. Is the cuff positioned differently, how do you keep the pressure gradient different? \

How does it work??

thanks

[merlin100]

okay, peaked my interest. I have read the mention of bifurcated and double lumen ETT. Is the cuff positioned differently, how do you keep the pressure gradient different? \

How does it work??

thanks

hi there.

i have sent you a CXR detailing the position of the double lumen ETT, and an anaesthetic web site you may find interesting. the tube is inserted as normal, but has 2 ports, enabling seperate ventilation of each lung. if you need more info, please e-mail me, and i will be only too happy to help.

http://www.anaesthesiauk.com/article.aspx?articleid=246

[email protected]

[gbr-77]

Two vents are used because some patients have a unilateral lung disorder/problem. By using 2 vents, you can "set" them differently. On the lung which has the disorder, you can set with higher Volume or Pressure. Compliance is decreased and/or Raw is increased for the "problem" lung thus making it harder to ventilate (push gas into lung to reach alveoli) than the "normal/healthier" lung. If you would "set" the patient up on only one ventilator with high Volume or Pressure, then the flow of gas to patient would be the "path of least resistance" (i.e. the normal lung). The normal lung would therefore be overdistended (concerns such as pneumothorax), while the "problem" lung would receive inadequate ventilated.