Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report
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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2014-11-01
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| Series: | Korean Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://ekja.org/upload/pdf/kjae-67-354.pdf |
| _version_ | 1819091157879095296 |
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| author | Dong Kyu Lee Sang Ho Lim Byung Gun Lim Sung Wook Kang Heezoo Kim |
| author_facet | Dong Kyu Lee Sang Ho Lim Byung Gun Lim Sung Wook Kang Heezoo Kim |
| author_sort | Dong Kyu Lee |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T22:35:16Z |
| format | Article |
| id | doaj.art-e9e913c7bcbb4193823ef353a2a4d414 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-21T22:35:16Z |
| publishDate | 2014-11-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-e9e913c7bcbb4193823ef353a2a4d4142022-12-21T18:47:59ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632014-11-0167535435710.4097/kjae.2014.67.5.3547950Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case reportDong Kyu Lee0Sang Ho Lim1Byung Gun Lim2Sung Wook Kang3Heezoo Kim4Department of Anesthesiology and Pain Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea.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.http://ekja.org/upload/pdf/kjae-67-354.pdfbronchial blockerone-lung ventilationpneumothorax |
| spellingShingle | Dong Kyu Lee Sang Ho Lim Byung Gun Lim Sung Wook Kang Heezoo Kim Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report Korean Journal of Anesthesiology bronchial blocker one-lung ventilation pneumothorax |
| title | Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report |
| title_full | Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report |
| title_fullStr | Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report |
| title_full_unstemmed | Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report |
| title_short | Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report |
| title_sort | management of traumatic pneumothorax with massive air leakage role of a bronchial blocker a case report |
| topic | bronchial blocker one-lung ventilation pneumothorax |
| url | http://ekja.org/upload/pdf/kjae-67-354.pdf |
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