We report a 26-year-old woman suffering from sepsis due to severe pneumonia successfully managed with sufficient irrigation of airpassages under differential lung ventilation (DLV). The patient had attempted suicide by jumping from a building, sustaining a unilateral pulmonary contusion, multiple rib fractures with hemothorax, liver injury, pelvic fracture, and open fractures of the lower leg. Although we successfully treated the multiple injuries, she went into septic shock due to severe bacterial pneumonia in the lung opposite the contused one. Both sputum and blood culture revealed Pseudomonas aeruginosa. Her condition did not improve despite antibiotic therapy specific to the organism. Frequent bronchoscopy with sufficient irrigation of the left bronchial tree appeared necessary to drain transbronchial pus. DLV was used to avoid hypoxemia and prevent the spread of infection to the opposite lung during irrigation. This airway management from day 21 after injury ameliorated bacterial infection and enabled her to recover from sepsis. DLV was maintained for 26 days and replaced by conventional ventilation through a single lumen tube. DLV thus was beneficial in sepsis due to severe unilateral pneumonia.
