Avtor/Urednik     Potočnik, Iztok; Kupsch, Andreas; Novak-Jankovič, Vesna
Naslov     Iatrogenic rupture of the trachea caused by double Lumen tube intubation
Tip     članek
Vir     Central European Journal of Medicine
Vol. in št.     Letnik 1, št. 6
Leto izdaje     2010
Obseg     str. 737-41
Jezik     eng
Abstrakt     Acute injuries of the tracheobronchial system are rare and life-threatening situations. Tracheal rupture most commonly occurs after blunt trauma to the chest. It is a rare but most concerning immediate complication of intubation. One-lung ventilation is required in lung surgery. Video assisted thoracoscopic procedures are an absolute indication for one-lung intubation. The double-lumen tube is the mainstay of one lung ventilation. Due to their larger size and rigidity, double lumen tubes are more difficult to insert, and complications are more common than with single lumen tubes. Opinions about the need for checking routinely the position of a double lumen tube by fiber optic bronchoscopy directly after intubation are divided. A 69-year-old woman with epidermoid lung carcinoma was scheduled for video assisted thoracoscopic left upper pulmonary lobectomy under general anaesthesia. The patient was prepared for the operation and itubated with the Carlens double lumen tube as usual. On introducing the camera into the thoracic cavity, the surgeon noted that the lungs were not completely collapsed. During blind adjustment the position of the tube the trachea was ruptured. The right-sided thoracotomy was performed and closed the greater part of the tracheal laceration. Only its upper 1.5-cm segment was surgically inaccessible because of the anatomical situation and thus remained unsutured. The patient received antibiotics, continuous airway humidification, analgesia with piritramide, and chest physiotherapy. She had no complications. In the literature, opinions about checking routinely the position of a double lumen tube by fiber optic bronchoscopy are divided. . Possibly, the very serious complication encountered in our patient could have been avoided, had the tube position been checked by bronchoscopy. (Abstract truncated at 2000 characters)
Deskriptorji     TRACHEA
RUPTURE
IATROGENIC DISEASE
INTUBATION, INTRATRACHEAL
BRONCHOSCOPY
AGED
FIBER OPTICS
LUNG NEOPLASMS
THORACOSCOPY
THORACOTOMY