Acute Attack of Asthma and Pulmonary Collapse Induced by Tracheal Intubation.
10.4097/kjae.1995.28.5.722
- Author:
Sung Won KIM
1
;
Jae Gon KIM
;
Joong Suk LEE
;
Byung Yon KWON
Author Information
1. Department of Anesthesiology, Wallace Memorial Baptist Hospital, Pusan, Korea.
- Publication Type:Case Report
- Keywords:
Attack of asthma;
Pulmonary collapse
- MeSH:
Aged;
Aminophylline;
Asthma*;
Bronchoscopy;
Emergencies;
Humans;
Intubation*;
Intubation, Intratracheal;
Ketamine;
Lidocaine;
Lung;
Lung Compliance;
Male;
Middle Aged;
Mucous Membrane;
Mucus;
Pancuronium;
Physical Examination;
Pulmonary Disease, Chronic Obstructive;
Respiratory Sounds;
Sutures;
Ventilation
- From:Korean Journal of Anesthesiology
1995;28(5):722-727
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Identification of the presence of chronic obstructive pulmonary disease in the elderly patient who was scheduled for surgery is vitally important. If appropriate therapeutic and preventive measures should not be instituted, tracheal intubation of the patient should be associated with a number of complications. We experienced a case of acute attack of asthma and pulmonary collapse during endotracheal intubation. A 54-year-old male who was scheduled for an emergency of primary corneo-scleral suture have had history of bronchial asthma. On the preoperative physical examination, there was no specific finding except expiratory wheezing. After endotracheal intubation with the aid of ketamine 2 mg/kg, pancuronium bromide 0.1 mg/kg and lidocaine 2 mg/kg, iv, acute asthmatic attack was appeared. Breathing sounds on the both lung fields can not be audible during manual ventilation and SpO(2) was dropped to 70% at F(1)O(2) 1.0. To relieve asthmatic attack, epinephrine(1: 1.000) 0.5 ml, sc, aminophylline 4 mg/kg, iv and methyprednisolone 1 mg/kg, iv were injected. Erosion of tracheal mucosa, blood clots and mucous plugs were found by the fibroptic bronchoscopy. After removal of blood clots and mucus, lung compliance and SpO2 were improved. The patient was discharged 7 days later without any complications or sequelae.
