Unilateral auto-PEEP in the recipient of a single lung transplant.
We report a patient who received a right single lung transplant (SLT) for progressive lymphangioleiomyomatosis and required reintubation for postoperative respiratory distress. She developed hemodynamic instability due to mediastinal shift from unilateral auto-PEEP with hyperinflation of the native lung. Placement of a double lumen endotracheal tube (DLET) and institution of differential lung ventilation restored equal lung inflation and hemodynamic stability.
Popple
C
C
Department of Cardiothoracic Anesthesia, Cleveland Clinic Foundation.
Higgins
T L
TL
McCarthy
P
P
Baldyga
A
A
Mehta
A
A
D000328:Adult; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D008168:Lung / Q000503:physiopathology*; D008175:Lung Neoplasms / Q000601:surgery; D016040:Lung Transplantation / Q000502:physiology*; D008203:Lymphangiomyoma / Q000601:surgery; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000379:methods*; D001261:Pulmonary Atelectasis / Q000628:therapy; D012121:Respiration, Artificial / Q000379:methods; D012131:Respiratory Insufficiency / Q000628:therapy*