Piccioni F et al. Use of the Ventrain Ventilation Device and an Airway Exchange Catheter to Manage Hypoxemia During Thoracic Surgery and One-Lung Ventilation. J Cardiothorac Vasc Anesth. 2021 Jun 25:S1053-0770(21)00529-2. doi: 10.1053/j.jvca.2021.06.023. Epub ahead of print. PMID: 34294514.

Dr. Piccioni and colleagues describe the use of Ventrain in combination with an airway exchange catheter to successfully manage hypoxemia during one lung ventilation. A 52-year-old female patient with normal preoperative lung function was scheduled for thoracoscopic pleural biopsies and talc pleurodesis. Two minutes upon initiation of one lung ventilation of the left lung, SpO2 decreased quickly from 98% to 84%, which could not be adequately restored by subsequent increase of FiO2, alveolar recruitment maneuver, or PEEP titration. An shortened airway exchange catheter was inserted through the tracheal lumen adapter of the double lumen tube and connected to Ventrain. EVA ventilation of the right lung was started using an oxygen flow of 6 L/min with a respiratory rate of about 20/min, which restored SpO2 to 98% within one minute. As the lung movements did not interfere with the surgeon’s work, the procedure could be finished without further problems. According to the authors, Ventrain is easier and safer to use compared to jet ventilation systems, which require a more specific training and carry a higher risk of barotrauma.