Ventilatory management in a child with bilateral bronchopleural fistula: A challenge for the intensivist

  • Tanvir Samra Department of Anesthesiology& Intensive Care, Post Graduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh (India)
  • Kamlesh Kumari Department of Anesthesiology& Intensive Care, Post Graduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh (India)
  • Vikas Saini Department of Anesthesiology& Intensive Care, Post Graduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh (India)
Keywords: Pneumatocele, Bronchopleural fistula, Ventilation, Intensive care

Abstract

Pneumatoceles have been described as a complication of staphylococcal pneumonia in children. But the management of large (>1 cm) bilateral bronchopleural fistula (BPF) in a child on positive pressure ventilation is a challenge for the intensivist. Bronchoscopy is an efficient method to close small BPFs (1-3 mm); independent lung ventilation cannot be used in patients with bilateral lung involvements; high frequency ventilation is of limited value in patients with distal and parenchymal disease; surgical management is deferred in patients with severe hypoxia and active chest infection. Extracorporeal membrane oxygenation is the only treatment modality left but its availability is limited to a few centers only.

 

Published
01-24-2019
How to Cite
Samra, T., Kumari, K., & Saini, V. (2019). Ventilatory management in a child with bilateral bronchopleural fistula: A challenge for the intensivist. Anaesthesia, Pain & Intensive Care, 217-220. Retrieved from https://mail.apicareonline.com/index.php/APIC/article/view/259
Section
Case Reports