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Selected Publication:
Ratzenhofer-Komenda, B; Offner, A; Kaltenböck, F; Maier, A; Pinter, H; Prause, G; Smolle-Jüttner, FM.
Differential lung ventilation and emergency hyperbaric oxygenation for repair of a tracheal tear.
Can J Anaesth. 2000; 47(2):169-175
Doi: 10.1007/BF03018855
(- Case Report)
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- Leading authors Med Uni Graz
- Ratzenhofer-Komenda Beatrice
- Co-authors Med Uni Graz
- Kaltenboeck Friedrich
- Maier Alfred
- Pinter Hans
- Prause Gerhard
- Smolle-Juettner Freyja-Maria
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- Abstract:
- To report the anaesthetic management of a case of tracheal rupture, using different types of ventilation and additional hyperbaric oxygenation (HBO). An 8 cm postintubation tracheal tear was repaired in a 66-yr-old woman with acute myocardial reinfarction, mediastinal and subcutaneous emphysema, cardiac failure and unrecognized lymphoma. Intraoperative monitoring included dual oximetry: arterial (SaO2) and mixed venous saturations (SvO2). Maintenance of free surgical access and a series of life-threatening events like dislocation of the jet catheter required many ventilation modes. An episode of supraventricular tachycardia was interrupted by cardioversion. Differential lung ventilation with a combination of conventional and high-frequency jet ventilation (HFJV) modes preserved oxygenation (PO2 139.2 mm Hg, PCO2 42.4 mm Hg, FiO2 1.0) until acute tube obstruction and decrease of saturation values (SaO2 58%, SvO2 45%) required emergency HBO: immediate cardiac and respiratory stabilization was provided by double-lung HFJV and apneic oxygenation under hyperbaric conditions at 2.5 atmospheres absolute for 35 min (SaO2 100%). The patient recovered from surgery but died of non-Hodgkin lymphoma. The combination of different ventilation modes including HFJV and the additional use of HBO resulted in sufficient oxygenation during tracheal repair.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Female -
- High-Frequency Jet Ventilation -
- Humans -
- Hyperbaric Oxygenation -
- Intubation, Intratracheal - adverse effects
- Respiration, Artificial -
- Trachea - injuries
- Trachea - surgery