TY - JOUR
T1 - Management of traumatic pneumothorax with massive air leakage
T2 - Role of a bronchial blocker: A case report
AU - Lee, Dong Kyu
AU - Lim, Sang Ho
AU - Lim, Byung Gun
AU - Kang, Sung Wook
AU - Kim, Heezoo
PY - 2014/1/1
Y1 - 2014/1/1
N2 - 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.
AB - 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.
KW - Bronchial blocker
KW - One-lung ventilation
KW - Pneumothorax
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U2 - 10.4097/kjae.2014.67.5.354
DO - 10.4097/kjae.2014.67.5.354
M3 - Article
AN - SCOPUS:84914169831
VL - 67
SP - 354
EP - 357
JO - Korean Journal of Anesthesiology
JF - Korean Journal of Anesthesiology
SN - 2005-6419
IS - 5
ER -