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Lee DK, Lim SH, Lim BG, et al. Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report. Korean J Anesthesiol. 2014;67(5):354-7doi: 10.4097/kjae.2014.67.5.354.
Lee, D. K., Lim, S. H., Lim, B. G., Kang, S. W., & Kim, H. (2014). Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report. Korean journal of anesthesiology, 67(5), 354-7. https://doi.org/10.4097/kjae.2014.67.5.354
Lee, Dong Kyu, et al. "Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report." Korean journal of anesthesiology vol. 67,5 (2014): 354-7. doi: https://doi.org/10.4097/kjae.2014.67.5.354
Lee DK, Lim SH, Lim BG, Kang SW, Kim H. Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report. Korean J Anesthesiol. 2014 Nov;67(5):354-7. doi: 10.4097/kjae.2014.67.5.354. Epub 2014 Nov 26. PMID: 25473467; PMCID: PMC4252350.
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Korean J Anesthesiol. 2014 Nov;67(5):354-7. doi: 10.4097/kjae.2014.67.5.354. Epub 2014 Nov 26.

Management of traumatic pneumothorax with massive air leakage: role of a bronchial blocker: a case report.

Korean journal of anesthesiology

Dong Kyu Lee, Sang Ho Lim, Byung Gun Lim, Sung Wook Kang, Heezoo Kim

Affiliations

  1. Department of Anesthesiology and Pain Medicine, Korea University Medical Center, Guro Hospital, Seoul, Korea.

PMID: 25473467 PMCID: PMC4252350 DOI: 10.4097/kjae.2014.67.5.354

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.

Keywords: Bronchial blocker; One-lung ventilation; Pneumothorax

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