Permissive hypercapnia with high-frequency oscillatory ventilation and one-lung isolation for intraoperative management of lung resection in a patient with multiple bronchopleural fistulae.
We report the use of high-frequency oscillatory ventilation in the operating room during repair of multiple bronchopleural fistulae in a 9-year-old boy. In addition, we used principles of permissive hypercapnia to further minimize barotrauma. There were no cardiovascular consequences due to either the high-frequency ventilation or the permissive hypercapnia. Our goals in employing this strategy were to minimize barotrauma, minimize gas flow through the fistulae, and optimize the surgical results.
Tietjen
C S
CS
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Simon
B A
BA
Helfaer
M A
MA
D001784:Blood Gas Analysis; D001983:Bronchial Fistula / Q000601:surgery*; D002245:Carbon Dioxide / Q000097:blood*; D002648:Child; D006612:High-Frequency Ventilation; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology*; D007430:Intraoperative Care; D008168:Lung / Q000601:surgery*; D008297:Male; D010995:Pleural Diseases / Q000601:surgery*; D011229:Preanesthetic Medication
D002245:Carbon Dioxide