Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report.
10.4097/kjae.2014.67.5.354
- Author:
Dong Kyu LEE
1
;
Sang Ho LIM
;
Byung Gun LIM
;
Sung Wook KANG
;
Heezoo KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea. kimheezoo@hotmail.com
- Publication Type:Case Report
- Keywords:
Bronchial blocker;
One-lung ventilation;
Pneumothorax
- MeSH:
Accidents, Traffic;
Adult;
Anesthesia;
Anoxia;
Chest Tubes;
Female;
Humans;
Lacerations;
Lung;
One-Lung Ventilation;
Oxygen;
Pneumothorax*;
Respiration, Artificial;
Thorax;
Ventilation
- From:Korean Journal of Anesthesiology
2014;67(5):354-357
- CountryRepublic of Korea
- Language:English
-
Abstract:
Massive air leakage through a lacerated lung produces inadequate ventilation and hypoxemia. Tube exchange from a single to double lumen endotracheal tube (DLT), and lung separation to maintain oxygenation, are challenging for seriously injured patients. In this case report, we aim to describe how a bronchial blocker (BB) makes it easier to perform a lung separation in this situation; it also increases the overall safety of the procedure. A 35-year-old female (163 cm, 47 kg) suffered from blunt chest trauma due to a traffic accident; the accident caused right-sided lung laceration with massive air leakage. Paradoxically, positive ventilation worsened SaO2 and leakage increased through a chest tube. We introduced BB while the patient was still awake: Left-side one-lung ventilation (OLV) was established and anesthesia was induced. After PaO2 was maximized with OLV, we changed the endotracheal tube to DLT without a hypoxic event. By BB placement, we maintained PaO2 at a secure level, conducted mechanical ventilation and exchanged the tube without deterioration.
