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

Pneumothorax
Air
One-Lung Ventilation
Lung
Ventilation
Chest Tubes
Traffic Accidents
Lacerations
Artificial Respiration
Accidents
Thorax
Anesthesia
Safety
Wounds and Injuries

Keywords

  • Bronchial blocker
  • One-lung ventilation
  • Pneumothorax

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Management of traumatic pneumothorax with massive air leakage : Role of a bronchial blocker: A case report. / Lee, Dong Kyu; Lim, Sang Ho; Lim, Byung Gun; Kang, Sung Wook; Kim, Heezoo.

In: Korean Journal of Anesthesiology, Vol. 67, No. 5, 01.01.2014, p. 354-357.

Research output: Contribution to journalArticle

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