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- Title
Airway management for a patient with tracheobronchomegaly undergoing lobectomy: a case report.
- Authors
Wang, Sai-Nan; Wu, An-Shi; Miao, Jin-Bai; Chen, Shuo; Jiang, Jia
- Abstract
Background: Tracheobronchomegaly (TBM) is a rare disorder mainly characterized by dilatation and malacia of the trachea and major bronchi with diverticularization. This will be a great challenge for airway management, especially in thoracic surgery requiring one-lung ventilation. Using a laryngeal mask airway and a modified double-lumen Foley catheter (DFC) as a "blocker" may achieve one-lung ventilation. This is the first report introducing this method in a patient with TBM. Case presentation: We present a 64-year-old man with TBM receiving left lower lobectomy. Preoperative chest computed tomography demonstrated a prominent tracheobronchial dilation and deformation with multiple diverticularization. The most commonly used double-lumen tube or bronchial blocker could not match the distorted airways. After general anesthesia induction, a 4# laryngeal mask was inserted, through which the modified DFC was positioned in the left main bronchus with the guidance of a fiberoptic bronchoscope. The DFC balloon was inflated with 10 ml air and lung isolation was achieved without any significant air leak during one-lung or two-lung ventilation. However, the collapse of the non-dependent lung was delayed and finally achieved by low-pressure artificial pneumothorax. The surgery was successful and the patient was extubated soon after the surgery. Conclusions: Using a laryngeal mask airway with a modified double-lumen Foley catheter acted as a bronchial blocker could be an alternative method to achieve lung isolation.
- Subjects
TRACHEAL diseases; CHEST X rays; AIRWAY (Anatomy); TRACHEA; ARTIFICIAL respiration; TREATMENT effectiveness; EXTUBATION; BRONCHI; LARYNGEAL masks; CATHETERIZATION; BRONCHIAL diseases; PNEUMONECTOMY; TRACHEA intubation; BRONCHOSCOPY; PNEUMOTHORAX
- Publication
BMC Anesthesiology, 2023, Vol 23, Issue 1, p1
- ISSN
1471-2253
- Publication type
Article
- DOI
10.1186/s12871-023-02324-5