Loer S, Fritz K W
Zentrum Anästhesie, Abt. 1, Medizinischen Hochschule Hannover.
Anaesthesiol Reanim. 1994;19(5):137-8.
The combination of two rare complications in intensive care caused an acute life-threatening situation. Following puncture of the left subclavian vein a pneumothorax developed over the course of a couple of days. The inserted thoracic drain dislocated into the subcutaneous tissue. During the induction of anaesthesia and controlled ventilation a tension pneumothorax developed. A decrease in oxygen saturation and an increase in the ventilation pressure led first to the diagnosis "malposition of the double lumen endotracheal tube", but its correct position could be confirmed by bronchoscopy. Finally, the tension pneumothorax was diagnosed by x-ray of the chest. This life-threatening situation could be treated by the insertion of a thoracic drain. The operation could be performed without any problems.
重症监护中两种罕见并发症的合并导致了急性危及生命的情况。在左锁骨下静脉穿刺后，数天内出现了气胸。插入的胸腔引流管移位至皮下组织。在麻醉诱导和控制通气期间，出现了张力性气胸。氧饱和度下降和通气压力升高首先导致诊断为“双腔气管导管位置不当”，但通过支气管镜检查可确认其正确位置。最后，通过胸部X线诊断为张力性气胸。这种危及生命的情况可通过插入胸腔引流管进行治疗。手术得以顺利进行。
