Independent lung ventilation (ILV) has been used successfully in the operating room during thoracic surgery. However its application in critical care medicine remains controversial. A 40-year-old man with alcoholism-induced acute pancreatitis developed sepsis, left-lung consolidation, and respiratory failure that was refractory to conventional ventilation techniques. A double-lumen tracheostomy tube was placed in preparation for ILV. Two ventilators were used in the assist-control mode permitting the patient's inspiration to trigger both machines simultaneously while allowing different expiratory times dictated by the individual lung's time constant. Suctioning became increasingly productive, clearing the lung consolidation, and in 2 days the patient was placed back on a single conventional ventilator. In less than 2 weeks, the patient had recovered and was discharged from the hospital.
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