Published online Jul 31, 2019. doi: 10.5492/wjccm.v8.i4.49
Peer-review started: March 15, 2019
First decision: June 6, 2019
Revised: June 21, 2019
Accepted: July 17, 2019
Article in press: July 17, 2019
Published online: July 31, 2019
Core tip: Severe unilateral lung disease presents a unique scenario where the diseased lung has very poor compliance, while the non-diseased lung remains normally compliant. In these patients, conventional positive pressure ventilation causes preferential distribution of tidal volume to the non-diseased lung causing its overdistension and inadvertent volutrauma. Placement of a double lumen endotracheal tube and providing independent lung ventilation, with a ventilator for each lung, can potentially minimize lung injury. This will allow institution of lung protective ventilation strategies to each lung, individualized based on their respective compliances.