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单腔气管插管治疗肺动脉破裂:应重新审视的老方法

Pulmonary Artery Rupture Management with a Single Lumen Endotracheal Tube: Old Tricks that Should be Revisited.

作者信息

Neerukonda Thanuja, Gibson William J, Abicht Travis, Sauer Andrew, Flynn Brigid C

机构信息

School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA.

Department of Cardiothoracic Surgery, University of Kansas Medical Center, Kansas City, KS, USA.

出版信息

Am J Case Rep. 2018 Mar 24;19:342-346. doi: 10.12659/ajcr.907211.

Abstract

BACKGROUND Pulmonary artery rupture can be a lethal complication of a pulmonary artery catheter (PAC). Different techniques have been used to manage PAC-induced pulmonary artery rupture, including double lumen endotracheal tube (DLT), bronchial blockers, pulmonary artery embolization, thoracotomy with hematoma evacuation, and extracorporeal life support for ventilation (ECLS). Single lumen endotracheal tube (ETT) is not frequently reported in the literature despite its advantages. CASE REPORT The authors present a case of PAC-induced pulmonary artery rupture successfully managed with a single lumen ETT. Although single lumen ETT is more labor intensive and requires constant critical care attention, the advantages of this technique are reported in this case in comparison to other well-documented therapies. CONCLUSIONS With on-going pulmonary bleeding, a single lumen ETT intubation offers advantages to the commonly advocated methods of treating a PAC-induced pulmonary artery rupture.

摘要

背景 肺动脉破裂可能是肺动脉导管(PAC)的致命并发症。已采用不同技术来处理PAC引起的肺动脉破裂,包括双腔气管插管(DLT)、支气管封堵器、肺动脉栓塞、开胸清除血肿以及体外生命支持通气(ECLS)。尽管单腔气管插管(ETT)有其优点,但文献中对此报道较少。病例报告 作者介绍了1例通过单腔ETT成功处理PAC引起的肺动脉破裂的病例。虽然单腔ETT操作更费力且需要持续的重症监护关注,但与其他有充分文献记载的治疗方法相比,本病例报道了该技术的优点。结论 在持续肺出血的情况下,单腔ETT插管相对于常用的治疗PAC引起的肺动脉破裂的方法具有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eb3/5882215/d352c9c56622/amjcaserep-19-342-g001.jpg

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