하행 대동맥류 수술에 적용한 일측폐 환기법에서 고빈도 Jet 환기법을 이용한 이중방식에 의한 독립적 폐환기

During surgical repair of a descending thoracic aorta aneurysm, one-lung ventilation improves visualization of the surgical field, facilitates surgical resection, and reduces lung trauma. Trauma to the left lung during surgical repair of the descending thoracic aorta is very common, and intrapulmonary hemorrhage can be occurred if both lungs are bentilated. A double lument tube can isolate and protect the lungs. During one lung ventilation in the lateral decrbi`tus position, hypoxemia can frequently occur and hypoxic damage can result. Selective nondependent lung high frequency jet ventilation was administered using a MERA JET VENTILATOR with FiO_2 1.0, driving gas pressure 1 kg/㎠, respiration rate 120/min., and an I.E ratio of 1:2 Oxygenation (PaO_2 readings were all above 200 torr) was well maintanined and PaCO_2 values were all within normal limits thoroughout the operation. Under the left atrial-femoral artery bypass with the cardiopulmonary bypass machine without oxygenator, an internal bypass graft with Woven dacron was performed. The patient tolerated the surgery well, and the postoperative course was uneventful except for left vocal cord paralysis.