A case of refractory pneumothorax and contralateral atelectasis after thoracoscopic subtotal esophagectomy treated with independent lung ventilation

JA Clinical Reports

Makiko Konda¹  Nobuhiro Tanaka¹  Natsuko Hirai¹  Yusuke Naito¹  Junji Egawa¹  Masahiko Kawaguchi¹ 

[1] Department of Anesthesiology, Nara Medical University;

关键词: Independent lung ventilation;    Positive end-expiratory pressures;    Pneumothorax;    Atelectasis;    Pneumonia;    Different lung diseases;   

DOI  :  10.1186/s40981-022-00537-0

来源: DOAJ

【 摘 要 】

Abstract Background Independent lung ventilation (ILV) allows separate positive end-expiratory pressures (PEEP) and inspiratory pressures for each lung. However, only a few articles have reported ILV management for lungs affected by different pathologies. Case presentation A 56-year-old man underwent video-assisted thoracic surgery for esophageal cancer. The right lung was injured during surgery, causing a bronchopleural fistula and necessitating chest drainage. On the third day in the intensive care unit, the patient’s oxygenation worsened during pressure support with continuous positive airway pressure ventilation. ILV was initiated for right-sided severe pneumothorax and left-sided atelectasis and pneumonia. ILV was continued for 2 days, and the patient’s trachea was successfully extubated the following day. Conclusion Applying high-level PEEP to the one lung and minimizing the airway pressure on the other lung could be achieved using ILV, which might contribute to successful tracheal extubation.

【 授权许可】

Unknown