Selective fiberoptic left main-stem intubation to treat bronchial laceration in an extremely low birth weight neonate.
A neonate born at 24 weeks gestation developed a right tension pneumothorax that persisted despite the placement of multiple thoracostomy tubes, the use of high-frequency ventilation and postural therapy. On day-of-life 11, bedside bronchoscopy revealed a laceration at the junction of the trachea and right main-stem bronchus. Under fiberoptic guidance the left main-stem bronchus was intubated. Single-lung ventilation then was employed for 24h, after which time the pneumothorax never recurred. We postulate that the diversion of positive-pressure ventilation away from the laceration site allowed the surrounding injury-induced granulation tissue to create a seal and facilitate closure of the defect.
Van Dorn
Charlotte S
CS
Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
Sittig
Steven E
SE
Koch
Cody A
CA
Thompson
Dana M
DM
Carey
William A
WA
D001980:Bronchi / Q000601:surgery*; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation*; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007440:Intubation / Q000295:instrumentation*; D022125:Lacerations / Q000000981:diagnostic imaging* / Q000601:surgery*; D013902:Radiography, Thoracic; D013907:Thoracostomy