Management of traumatic pneumothorax with massive air leakage: Role of a bronchial blocker: A case report
- Authors
- Lee, D.K.; Lim, S.H.; Lim, B.G.; Kang, S.W.; Kim, H.
- Issue Date
- 2014
- Publisher
- Korean Society of Anesthesiologists
- Keywords
- Bronchial blocker; One-lung ventilation; Pneumothorax
- Citation
- Korean Journal of Anesthesiology, v.67, no.5, pp.354 - 357
- Indexed
- SCOPUS
KCI
- Journal Title
- Korean Journal of Anesthesiology
- Volume
- 67
- Number
- 5
- Start Page
- 354
- End Page
- 357
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/100734
- DOI
- 10.4097/kjae.2014.67.5.354
- ISSN
- 2005-6419
- 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. © the Korean Society of Anesthesiologists, 2014.
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