Whole-lung lavage complicated with pneumothorax: a case report.
10.4097/kjae.2017.70.4.462
- Author:
Hyun Joo AHN
1
;
Mikyung YANG
;
Jie Ae KIM
;
Burnyoung HEO
;
Jin Kyoung KIM
;
So Yoon PARK
Author Information
1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. anesyang@skku.edu
- Publication Type:Case Report
- Keywords:
Bronchoalveolar lavage;
Pneumothorax;
Pulmonary alveolar proteinosis
- MeSH:
Anoxia;
Auscultation;
Bronchoalveolar Lavage;
Chest Tubes;
Humans;
Lung;
One-Lung Ventilation;
Pneumothorax*;
Pulmonary Alveolar Proteinosis;
Therapeutic Irrigation*;
Thorax;
Tidal Volume
- From:Korean Journal of Anesthesiology
2017;70(4):462-466
- CountryRepublic of Korea
- Language:English
-
Abstract:
A patient with pulmonary alveolar proteinosis underwent whole lung lavage of the right lung. Lavage of the left lung was not immediately possible because of severe hypoxemia. Three days later, after correction of hypoxemia, we re-attempted the left lung lavage. However, the patient had severe hypoxemia (SpO₂< 80%) within a few minutes of performing right one lung ventilation (OLV). On bronchoscopic examination, proper tube location was confirmed. Bronchodilator nebulization and steroid injection were attempted with no effect. While searching for the cause of the hypoxemia, we found that the breath sound from the right lung had become very weak and distant compared with that from initial auscultation. Right pneumothorax was diagnosed on chest X-ray and a chest tube was inserted. After confirming pneumothorax resolution, we re-tried right OLV and were able to proceed with the left lung lavage without signs of aggravating air leak, loss of tidal volume, or severe hypoxemia.
