single lung ventilation

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Recently there was a pt. with a transmediastinal GSW. The esophagus was
injured, repaired and developed a leak so the pt. developed mediastinitis
and was quite ill. When his ET tube became dislodged he almost died. The
left lung was full of blood and crap and was not contributing in any useful
way. It was determined that he would benefit from R lung ventilation but
everyone was scared to change the tube after his recent near death
experience. So Rocky had a resident attach a large diameter tube to the
first one, and advance the whole thing into the R bronchus. It worked great.
I don't know if any of you have had a similar experience.

Rob Smith, M.D.

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