Fatal pulmonary haemorrhage during anaesthesia for bronchial artery embolization in cystic fibrosis.
Three children with cystic fibrosis (CF) had significant pulmonary haemorrhage during anaesthetic induction prior to bronchial artery embolization (BAE). Haemorrhage was associated with rapid clinical deterioration and subsequent early death. We believe that the stresses associated with intermittent positive pressure ventilation (IPPV) were the most likely precipitant to rebleeding and that the inability to clear blood through coughing was also an important factor leading to deterioration. Intermittent positive pressure ventilation should be avoided when possible in children with CF with recent significant pulmonary haemorrhage.
McDougall
R J
RJ
Department of Anaesthesia and Respiratory Medicine, Royal Children's Hospital, Parkville, Melbourne, Victoria, Australia.
Sherrington
C A
CA
D000293:Adolescent; D000768:Anesthesia, General / Q000009:adverse effects; D001981:Bronchial Arteries; D002648:Child; D003371:Cough / Q000503:physiopathology; D003550:Cystic Fibrosis / Q000150:complications / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D017809:Fatal Outcome; D005260:Female; D006469:Hemoptysis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation / Q000009:adverse effects; D007431:Intraoperative Complications; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D011175:Positive-Pressure Respiration / Q000009:adverse effects; D012008:Recurrence; D012131:Respiratory Insufficiency / Q000209:etiology