Thoracics

2020 ◽  
pp. 215-246
Author(s):  
James Bennett ◽  
Gerard Gould
Keyword(s):  
Best Practice ◽  
Bronchopleural Fistula ◽  
Management Strategies ◽  
Lung Ventilation ◽  
Bronchial Obstruction ◽  
Dynamic Hyperinflation ◽  
One Lung Ventilation ◽  
Cardiac Herniation ◽  
Life Threatening ◽  
Practice Methods

In this chapter on life-threatening thoracic problems in anaesthesia, the authors offer their guidance and expertise on the best-practice methods of dealing with each of these. These problems include tracheal/bronchial obstruction, inhaled foreign body, tracheal injury or laceration, bronchopleural fistula, hypoxia/pneumothorax/high airway pressure during one-lung ventilation, dynamic hyperinflation, cardiac herniation postpneumonectomy, major airway bleeding, and bleeding during mediastinoscopy. In addition, the definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations for each potential thoracically related situation are given and elaborated upon. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

Thoracics

2009 ◽  
pp. 209-234
Keyword(s):  
Foreign Body ◽  
Airway Pressure ◽  
Bronchopleural Fistula ◽  
Lung Ventilation ◽  
Bronchial Obstruction ◽  
Dynamic Hyperinflation ◽  
Dependent Lung ◽  
Tracheal Injury ◽  
One Lung Ventilation ◽  
Cardiac Herniation

Intrathoracic tracheal/bronchial obstruction 210 Inhaled foreign body 212 Tracheal injury or laceration 214 Bronchopleural fistula (BPF) 216 Hypoxia during one-lung ventilation (OLV) 218 Sudden high airway pressure during one-lung ventilation 220 Pneumothorax of dependent lung during one-lung ventilation 222 Dynamic hyperinflation (DHI) 224 Cardiac herniation postpneumonectomy ...

scholarly journals Thoracic Anesthesia and Cross Field Ventilation for Tracheobronchial Injuries: A Challenge for Anesthesiologists

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sankalp Sehgal ◽  
Joshua C. Chance ◽  
Matthew A. Steliga
Keyword(s):  
Pain Control ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Lung Ventilation ◽  
Postoperative Pain Control ◽  
One Lung Ventilation ◽  
Tracheal Reconstruction ◽  
Thoracic Anesthesia ◽  
Tracheobronchial Injuries ◽  
Life Threatening

Tracheobronchial injuries are rare but life threatening sequel of blunt chest trauma. Due to the difficult nature of these injuries and the demanding attributes of the involved surgery, the anesthesiologist faces tough challenges while securing the airway, controlling oxygenation, undertaking one-lung ventilation, maintaining anesthesia during tracheal reconstruction, and gaining adequate postoperative pain control. Amongst the few techniques that can be used with tracheobronchial injuries, cross field ventilation is a remotely described and rarely used technique, especially in injuries around the carina. We effectively applied cross field ventilation in both our cases and the outcome was excellent.

Thoracic surgery

2018 ◽  
Author(s):  
Claire Todd ◽  
Bruce McCormick
Keyword(s):  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Bronchopleural Fistula ◽  
Lung Ventilation ◽  
Anaesthetic Management ◽  
Rigid Bronchoscopy ◽  
Stent Insertion ◽  
One Lung Ventilation ◽  
Chest Injuries

This chapter discusses the anaesthetic management of thoracic surgery. It begins with general principles of thoracic surgery, including isolation of the lungs, one-lung ventilation, and providing analgesia for thoracic surgery. Surgical procedures covered include rigid bronchoscopy and bronchial stent insertion, mediastinoscopy, wedge resection, lobectomy, pneumonectomy, thoracoscopy and video-assisted thoracoscopic surgery, drainage of empyema and decortications, lung volume reduction surgery and bullectomy, repair of bronchopleural fistula, pleurectomy and pleurodesis, oesophagectomy, and surgical management of chest injuries.

scholarly journals “Life-threatening” Hypoxemia in One-lung Ventilation

2011 ◽  
Vol 115 (2) ◽  
pp. 438-438 ◽  
Author(s):  
Ravi S. Tripathi ◽  
Thomas J. Papadimos
Keyword(s):  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Life Threatening

scholarly journals Dynamic hyperinflation and cardiac arrest during one-lung ventilation: a case report

2011 ◽  
Vol 58 (4) ◽  
pp. 396-400 ◽  
Author(s):  
Katherine Marseu ◽  
Peter Slinger ◽  
Marc de Perrot ◽  
Karen McRae ◽  
Martin Ma
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Lung Ventilation ◽  
Dynamic Hyperinflation ◽  
One Lung Ventilation

scholarly journals Contralateral tension pneumothorax during video-assisted thoracic surgery for lung cancer in a patient with obesity and rib fractures: a case report and review of the literature

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Sakiko Kumata ◽  
Katsunari Matsuoka ◽  
Shinjiro Nagai ◽  
Mitsuhiro Ueda ◽  
Yoshinori Okada ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Past History ◽  
Tension Pneumothorax ◽  
Lung Ventilation ◽  
Rib Fractures ◽  
Review Of The Literature ◽  
One Lung Ventilation ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Abstract Background Intraoperative contralateral pneumothorax during one-lung ventilation is a rare but life-threatening complication. Although the exact incidence is unknown, only 14 cases with this complication have been reported until now. Case presentation A 67-year-old Japanese man with a weight of 80 kg, height of 162.2 cm, and body mass index of 30.4 kg/m2 underwent three-port video-assisted thoracic surgery for lung cancer with one-lung ventilation. He had suffered from traumatic right rib fractures 6 weeks before the referral. Fifteen minutes before the end of the surgery, the systolic blood pressure suddenly dropped to about 50 mmHg, which was immediately recovered by intravenous injection of phenylephrine. This episode occurred during chest closure after the completion of the left upper lobectomy, and one-lung ventilation was soon switched to two-lung ventilation. Contralateral tension pneumothorax was noted by the postoperative chest x-ray. As the patient was complicated with obesity and a past history of rib fractures, increased airway pressure during one-lung ventilation related to obesity together with the persistent compression of the visceral pleura by the fractured ends of the ribs was considered to be the factors responsible for this critical complication. Conclusions Patient backgrounds such as obesity and past history of rib fractures should be noted carefully as risk factors for intraoperative contralateral pneumothorax during one-lung ventilation. We present the clinical course and discuss the mechanism of development of this potentially life-threatening complication in the present case with a review of the literature.

Thoracic surgery

2021 ◽  
pp. 529-556
Author(s):  
Charlotte Earnshaw ◽  
Kajan Kamalanathan
Keyword(s):  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Bronchopleural Fistula ◽  
Lung Ventilation ◽  
Rigid Bronchoscopy ◽  
Stent Insertion ◽  
One Lung Ventilation ◽  
Chest Injuries ◽  
Bronchial Stent

This chapter discusses the anaesthetic management of thoracic surgery. It begins with general principles of thoracic surgery, including isolation of the lungs, one-lung ventilation, and providing analgesia for thoracic surgery. Surgical procedures covered include rigid bronchoscopy and bronchial stent insertion; mediastinoscopy; wedge resection; lobectomy; pneumonectomy; thoracoscopy and video-assisted thoracoscopic surgery (VATS); drainage of empyema and decortications; lung volume reduction surgery and bullectomy; repair of bronchopleural fistula; pleurectomy and pleurodesis; oesophagectomy and surgical management of chest injuries.

Face-To-Face Double-Lumen Tube Intubation With the Airtraq Video Laryngoscope for Emergency Thoracic Surgery: A Case Report

2021 ◽  
pp. 108925322110076
Author(s):  
Yacine Ynineb ◽  
Emilie Boglietto ◽  
Francis Bonnet ◽  
Christophe Quesnel ◽  
Marc Garnier
Keyword(s):  
Thoracic Surgery ◽  
Bronchopleural Fistula ◽  
Rapid Sequence Induction ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lumen Tube ◽  
Face To Face ◽  
High Flow Oxygen

Double-lumen intubation is commonly used for thoracic surgery as it allows rapid and effective one-lung ventilation. However, it is more difficult than single-lumen tube intubation, notably in the context of emergency surgery and/or in hypoxemic patients. We report the case of a 57-year-old patient requiring emergency revision surgery after an upper right lobectomy due to postoperative pneumothorax and pleuropneumonia. As rapid lung isolation was required due to a bronchopleural fistula, rapid sequence induction and double-lumen tube intubation were performed. In addition, as the patient was hypoxemic with incomplete pre-oxygenation and too uncomfortable to tolerate the recumbent position despite high-flow oxygen, intubation was performed in face-to-face position. The patient was successfully intubated in 22 seconds and the right lung immediately isolated, allowing the surgeon to clean the pleural cavity. This is the first report of a double-lumen tube intubation in face-to-face position. The expected difficulties related to this type of intubation were successfully prevented using an Airtraq laryngoscope. Although such a strategy cannot be recommended from this one case, this report is encouraging for future studies evaluating the potential advantages of Airtraq use for double-lumen face-to-face intubation for emergency thoracic surgery.

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