Hypoxemia during one-lung ventilation: jet ventilation of the middle and lower lobes during right upper lobe sleeve resection.

Abstract

A 64-yr-old man underwent right thoracotomy and upper lobectomy for lung carcinoma. Hypoxemia on one-lung ventilation was being managed with continuous positive airway pressure to the nondependent lung when a sleeve resection had to be performed. As this positive airway pressure would no longer be maintained with the bronchus open, an alternate method of oxygenation was necessary. This report describes the successful use of jet ventilation via an airway exchange catheter placed in the bronchus intermedius through the tracheal lumen of a left-sided double-lumen endobronchial tube. Oxygenation was maintained and surgical access was good during the 15-min resection.