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Combined differential lung ventilation and inhaled nitric oxide therapy in the management of unilateral pulmonary contusion.

Unilateral pulmonary contusion after blunt thoracic trauma can prove to be a devastating injury. Regional disturbances in blood flow and alveolar ventilation can significantly alter pulmonary function. We present a case report of unilateral pulmonary contusion that resulted in significant pulmonary dysfunction. This patient was successfully managed with multimodality therapy consisting of differential lung ventilation and inhaled nitric oxide. The effect of nitric oxide applied to the "normal" lung, the "injured" lung, and both lungs is described. The use of inhaled nitric oxide was associated with an increase in oxygenation when applied to the normal or both lungs. The use of nitric oxide in conjunction with differential lung ventilation appeared to offer benefit in this patient with severe unilateral pulmonary contusion.