Application of positive end-expiratory pressure in a case with large laceration on the superior vena cava.
Iatrogenic injury is a difficult situation for a surgeon. Being successful in saving a patient at risk is the major concern in this situation. Once an iatrogenic injury to the superior vena cava (SVC) is found, increasing the intrathoracic pressure is theoretically able to overcome the venous pressure and to alleviate or even stop bleeding from injury. A 76-year-old female patient, who had suffered from end-stage diabetic nephropathy, developed tension hemothorax during insertion of the cuffed hemodialysis catheter. The successful course of resuscitation without emergent operation or endovascular repair is presented here.
Chao
Chia Sheng
CS
Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, No 2, Chung-Cheng 1st Rd, Kaohsiung, 802, Taiwan, ROC. cvschao@gmail.com
Chao
Chia Ting
CT
Chin
Hsien Kuo
HK
Chang
Yee Phoung
YP
D000368:Aged; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D022125:Lacerations / Q000209:etiology*; D011030:Pneumothorax / Q000209:etiology* / Q000628:therapy; D011175:Positive-Pressure Respiration / Q000379:methods*; D006435:Renal Dialysis; D012769:Shock / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000293:injuries*