Independent lung ventilation was developed to facilitate the anesthetic management of thoracic surgery patients. The Carlens double-lumen endotracheal tube (DLT), introduced in 1949, provided physicians with the ability to ventilate independently each lung or ventilate selectively one lung. Subsequent refinements in the techniques of independent lung ventilation as well as the advent of newer generations of DLTs have led to DLTs becoming the method of choice for independent lung ventilation in the operating room.

These techniques subsequently have been applied in the critical care setting by intensivists when independent lung ventilation is required. This article describes techniques to separate effectively the lungs and the clinical considerations involved in independent lung ventilation.