Severe pulmonary edema occurred during endobronchial ultrasound under monitored anesthesia care - A case report -
- Author:
Hwan Yong CHOI
1
;
Hyung Koo KANG
;
Min Hee HEO
;
Sang Il LEE
;
Ji Yeon KIM
;
Kyung-Tae KIM
;
Jang Su PARK
;
Won Joo CHOE
;
Kyung Woo KIM
;
Jun Hyun KIM
Author Information
- Publication Type:Case Report
- From:Anesthesia and Pain Medicine 2023;18(4):439-444
- CountryRepublic of Korea
- Language:English
- Abstract: Endobronchial ultrasound (EBUS) is widely used to diagnose lung cancer. Monitored anesthesia care (MAC) can enhance patient comfort and procedural conditions during EBUS. EBUS under MAC is usually safe but can lead to various complications. Case: A 34-year-old male who had increased sputum for two months showed an enlarged paratracheal lymph node and planned for lymph node biopsy by EBUS. During EBUS under MAC, an unexpected oxygen saturation decline required intervention. After intubation, copious frothy fluid was suctioned from the bronchi, and oxygenation was recovered. A narrowed trachea and the EBUS bronchoscope might have resulted in upper airway obstruction, and suction performed under these conditions might have caused pulmonary edema. The patient received non-invasive ventilation and high-flow nasal cannula and recovered without complications. Conclusions: When there is an expected risk of upper airway obstruction during EBUS, careful preoperative evaluation and preparation are essential to prevent negative pressure pulmonary edema.
