Management of traumatic pneumothorax with massive air leakage: Role of a bronchial blocker: A case report

Dong Kyu Lee, Sang Ho Lim, Byung Gun Lim, Sung Wook Kang, Heezoo Kim

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)354-357
Number of pages4
JournalKorean Journal of Anesthesiology
Volume67
Issue number5
DOIs
Publication statusPublished - 2014 Jan 1

    Fingerprint

Keywords

  • Bronchial blocker
  • One-lung ventilation
  • Pneumothorax

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this