• D F Zandstra and C P Stoutenbeek.
• Afdeling voor Anaesthesiologie en Intensive Care, Academisch Ziekenhuis Groningen, The Netherlands.
• Intensive Care Med. 1989 Jan 1; 15 (3): 151-4.

AbstractSeventeen polytrauma patients with asymmetric pulmonary contusion were treated with differential lung ventilation (DLV). The ratios of differential values of end-tidal CO2 concentration (ETCO2) and CO2 excretion ml/min (VCO2) were compared as indirect parameters for differential pulmonary perfusion. Both CO2-derived methods indicated asymmetry after starting DLV suggesting asymmetric pulmonary perfusion as a consequence of contusion. Prior to stopping DLV a significant improvement in asymmetry was indicated by the differential ratios of ETCO2 and VCO2 values. The ETCO2 ratio increased from 0.74 +/- 0.17 to 0.88 +/- 0.10, the VCO2 ratio from 0.57 +/- 0.23 to 0.86 +/- 0.11. In two patients with very severe contusion who underwent bilobectomies a marked difference between the ratios of ETCO2 and VCO2 was observed. It is concluded that differential measurement of CO2-derived variables may be useful in indicating differential perfusion in clinical practice on DLV. In very severe asymmetric contusion ETCO2 ratios may underestimate the differential perfusion ratio.

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