Ventilation during lung separation procedures

Enough working space for the surgeon is of utmost importance to enable an adequate surgical performance. Lung isolation techniques have been developed to increase this crucial working space by deflating one of the lungs and ventilating the other one. A major drawback of one lung ventilation is the increased risk of hypoxemia (i.e. arterial oxygenation <90%), which may develop due to ventilation-perfusion mismatch and dissociation of O2 from hemoglobin (Bohr effect). Oxygenation of the deflated non-dependent lung might be required in this case, using continuous positive airway pressure (CPAP). However, this is not always sufficient and can result in an undesired re-inflation of the lung.

 

The scenario above can be prevented using the patented EVA technology, which now enables full ventilation of the non-dependent lung without re-inflation.

 

EVA technology for ventilation of the non-dependent lung

With the patented EVA technology it is now possible to fully ventilate the non-dependent lung. Its assisted expiration capacities enable effective additional ventilation in order to prevent or rapidly overcome cases of hypoxemia. Additionally, the non-dependent lung remains collapsed during EVA ventilation, which means no delay or postponement of surgery. The EVA technology is also enhancing collapse initiation, ultimately resulting in a more effective collapse. Our manual ventilation device Ventrain, based on the EVA technology, can be used together with a double lumen tube or a bronchial blocker during these lung isolation procedures.

 

Ventrain together with a double lumen tube

Ventrain is a valuable tool when additional ventilation through a double lumen tube is desired. A small endotracheal tube (e.g. tube exchange catheter or intubating introducer; ID 2 -3 mm) is inserted in the bronchial lumen of the double lumen tube, after which it is connected to Ventrain. Ventilation with a mild flow (2-6 L/min; 100% O2) will prevent or overcome hypoxemia, while the lung remains deflated.

 

Ventrain together with a bronchial blocker

Should a lung need to be collapsed in a patient already exhibiting airway difficulties, a bronchial blocker to isolate the lung might be used. Ventrain can be directly connected to a bronchial blocker. The EVA technology implemented in Ventrain subsequently enables full ventilation through the small bore blockers. The non-dependent lung still continues to remain collapsed during this ventilation method.

 

 

Advantages of expiration by suction during lung isolation techniques:

  • full ventilation (oxygenation and active CO2 removal);
  • no re-inflation of the independent lung;
  • minimally invasive insertion (e.g. ID 1.6 mm);
  • selective blockage of specific lobe possible;
  • lung collapse drastically shortened;
  • good mobilization of mucus.

 

©2016 Ventrain, Cricath, Tritube, Evone and the EVA technology are registered trademarks of Ventinova Medical B.V. All rights reserved.

Products

  • Now Available! Tritube

    Tritube is an ultra-thin ventilation tube for adult patients. It provides easy access to the airway, a secured airway and a spacious surgical site.

    Read more
  • Ventrain

    Ventrain  not only supplies oxygen during the inspiration phase, but also actively removes gas from the lungs with Expiratory Ventilation Assistance.

    Read more
  • Cricath

    Cricath is a flexible 2 mm needle catheter for quick and easy cricothyrotomy. A number of smart features result in easier handling and reduced risk of kinking.

    Read more
  • Ventrain Emergency Kit

    The Ventrain Emergency Kit contains Ventrain and Cricath in one kit for full ventilation in a ‘Cannot Intubate, Cannot Ventilate’ situation.

    Read more
Read more

Small Lumen Ventilation

Small Lumen Ventilation

The unique and proprietary Expiratory Ventilation Assistance technology, also known as EVA, actively induces expiration. EVA shortens expiration time, increases the achievable minute volume and reduces the risk of air trapping.

Read more