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Use of a double-lumen endotracheal tube with independent lung ventilation for treatment of refractory atelectasis.

Clinicians have long been concerned with the management of atelectasis. Numerous techniques have been described to reverse atelectasis in one or more lobes of the lung. The techniques employed have included chest physiotherapy, transnasal tracheal suctioning, translaryngeal instillation of saline or mucolytic agents into the trachea, intermittent positive pressure breathing (IPPB), and bronchoscopy (1). We describe the use of independent ventilation with differential positive end-expiratory pressure (PEEP) for treatment of refractory lobar atelectasis.