Cardiovascular Collapse after the Induction of Anesthesia Due to the MASS Effect of Unruptured Giant Bullae
<i>Background and Objectives</i>: Giant bullae rupture easily and cause tension pneumothorax, which can cause problems during general anesthesia. However, the hemodynamic instability that can occur due to the mass effect of an unruptured giant bulla should not be overlooked. <i>Cas...
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MDPI AG
2023-09-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/9/1689 |
| _version_ | 1797578863113404416 |
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| author | Junghyun Park Dulee Kim Jae-Hoo Park Ji-Yun Lee Eun-Jung Cho |
| author_facet | Junghyun Park Dulee Kim Jae-Hoo Park Ji-Yun Lee Eun-Jung Cho |
| author_sort | Junghyun Park |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Giant bullae rupture easily and cause tension pneumothorax, which can cause problems during general anesthesia. However, the hemodynamic instability that can occur due to the mass effect of an unruptured giant bulla should not be overlooked. <i>Case report</i>: A 43-year-old male patient visited the emergency room with an abdominal wound. There was a giant emphysematous bulla in the left lung. Emergency surgery was decided upon because there was active bleeding according to abdominal CT. After tracheal intubation, the patient’s blood pressure and pulse rate dramatically decreased. His blood pressure did not recover despite the use of vasopressors and discontinuation of positive pressure ventilation applied to the lungs. Thus, a bullectomy was immediately performed. The patient’s blood pressure and pulse rate were normalized after the bullectomy. <i>Conclusions</i>: If emergency surgery under general anesthesia is required in a patient with a giant emphysematous bulla, it is safe to minimize positive pressure ventilation and remove the giant emphysematous bulla as soon as possible before proceeding with the remainder of the surgery. Tension pneumothorax due to the rupturing of a bulla should be considered first. However, hemodynamic changes might occur due to the mass effect caused by a giant bulla. |
| first_indexed | 2024-03-10T22:28:44Z |
| format | Article |
| id | doaj.art-211ff7e314e44315ab0cdd02ead473c1 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T22:28:44Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-211ff7e314e44315ab0cdd02ead473c12023-11-19T11:53:31ZengMDPI AGMedicina1010-660X1648-91442023-09-01599168910.3390/medicina59091689Cardiovascular Collapse after the Induction of Anesthesia Due to the MASS Effect of Unruptured Giant BullaeJunghyun Park0Dulee Kim1Jae-Hoo Park2Ji-Yun Lee3Eun-Jung Cho4Department of Anesthesiology and Pain Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of Korea<i>Background and Objectives</i>: Giant bullae rupture easily and cause tension pneumothorax, which can cause problems during general anesthesia. However, the hemodynamic instability that can occur due to the mass effect of an unruptured giant bulla should not be overlooked. <i>Case report</i>: A 43-year-old male patient visited the emergency room with an abdominal wound. There was a giant emphysematous bulla in the left lung. Emergency surgery was decided upon because there was active bleeding according to abdominal CT. After tracheal intubation, the patient’s blood pressure and pulse rate dramatically decreased. His blood pressure did not recover despite the use of vasopressors and discontinuation of positive pressure ventilation applied to the lungs. Thus, a bullectomy was immediately performed. The patient’s blood pressure and pulse rate were normalized after the bullectomy. <i>Conclusions</i>: If emergency surgery under general anesthesia is required in a patient with a giant emphysematous bulla, it is safe to minimize positive pressure ventilation and remove the giant emphysematous bulla as soon as possible before proceeding with the remainder of the surgery. Tension pneumothorax due to the rupturing of a bulla should be considered first. However, hemodynamic changes might occur due to the mass effect caused by a giant bulla.https://www.mdpi.com/1648-9144/59/9/1689giant emphysematous bullamass effectcardiovascular collapsebullectomy |
| spellingShingle | Junghyun Park Dulee Kim Jae-Hoo Park Ji-Yun Lee Eun-Jung Cho Cardiovascular Collapse after the Induction of Anesthesia Due to the MASS Effect of Unruptured Giant Bullae Medicina giant emphysematous bulla mass effect cardiovascular collapse bullectomy |
| title | Cardiovascular Collapse after the Induction of Anesthesia Due to the MASS Effect of Unruptured Giant Bullae |
| title_full | Cardiovascular Collapse after the Induction of Anesthesia Due to the MASS Effect of Unruptured Giant Bullae |
| title_fullStr | Cardiovascular Collapse after the Induction of Anesthesia Due to the MASS Effect of Unruptured Giant Bullae |
| title_full_unstemmed | Cardiovascular Collapse after the Induction of Anesthesia Due to the MASS Effect of Unruptured Giant Bullae |
| title_short | Cardiovascular Collapse after the Induction of Anesthesia Due to the MASS Effect of Unruptured Giant Bullae |
| title_sort | cardiovascular collapse after the induction of anesthesia due to the mass effect of unruptured giant bullae |
| topic | giant emphysematous bulla mass effect cardiovascular collapse bullectomy |
| url | https://www.mdpi.com/1648-9144/59/9/1689 |
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