Bilateral Vents

mountain_rn · Oct 5, 2005

At one time I had cared for a pt with beta-thalesmia major who had a mucoid removed. This patients ability to recieve positive pressure ventilation was inpeded due to poor tissue healing on his operative lung. Thus, due to "leaking" that is communicated thru the incision, then thru the CT we were forced to independently ventilate each lung. The inspiratory trigger had to be set more "negative" on the operative lung requiring two different vent settings. It didn't work out so well for the pt but I am sure some pulmonary fellow wrote a great paper on it. Peace. :uhoh21:

mojo4221 · Oct 5, 2005

I have also worked with the double lumen ETT. A gentleman drove his van into a tree @ a high rate of speed. He severely injuried both lung fields, thus making it extremely hard to ventilate him and get his "sats" up. The trauma attending decided to try the double lumen ETT. Unfortunately, the man had sustained too many injuries and died. I do not wish to sound morbid,but it was interesting seeing the ventilation technique of this specialty tube. Using different levels of PEEP, tidal volumes,etc..

AlexCCRN · Oct 11, 2005

HeartQueen... I'm thinking you'd intubate the right mainstem, cuffed at that level, the outer lumen would ventilate the left distal to a second cuff - must be two cuffs... just thinking out loud.

suzanne4, RN · Oct 11, 2005

There are two cuffs. You actually use this type of ETT in the OR doing lung surgery all of the time, just that many times the patient is reintubated with a single lumen tube at the end of procedure before the patient is transferred out of the OR.

ICURRT · Oct 30, 2008

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

It is called a carlens tube and it has an extension with a seperate balloon to seal off the other lung. Two ventilators are used, each with seperate settings.