title: Selective fiberoptic left main-stem intubation for severe unilateral barotrauma in a 24-week premature infant.
abstract: A 24-week premature infant developed severe right-sided pulmonary barotrauma secondary to mechanical ventilation for respiratory distress syndrome (RDS). High-frequency oscillatory ventilation and permissive hypercapnia were initiated. A chest tube was placed to relieve a pneumothorax, and a catheter was inserted into an air-filled cyst for drainage. These maneuvers failed to improve the child's respiratory status. The child's left main-stem bronchus was then successfully fiberoptically intubated for single-lung ventilation in order to reduce the unilateral barotrauma. Single-lung ventilation was effectively and safely continued for 5 days, with complete resolution of the pulmonary barotrauma.
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Meyer
authors.forename: Tom B
authors.initials: TB
authors.lastname: Rice
authors.forename: John C
authors.initials: JC
authors.lastname: Glaspey
mesh_terms: D001469:Barotrauma / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007442:Intubation, Intratracheal / Q000379:methods*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D016896:Treatment Outcome