Differential lung physiotherapy using a double lumen tube in flail chest and refractory lung atelectasis.

The management of refractory lung atelectasis in a patient with flail chest can be difficult. Treatment of lung atelectasis is complicated by practical problems with the application of chest physiotherapy, postural drainage and incentive spirometry. Although double lumen endotracheal tubes have been used in such cases for the purpose of differential lung ventilation, the use of differential lung physiotherapy has not been reported before. This report describes the successful application of this technique in a patient with flail chest and refractory lung atelectasis.