Case report: separation from cardiopulmonary bypass with a rigid bronchoscope airway after hemoptysis and bronchial impaction with clot.
Hemoptysis after cardiopulmonary bypass (CPB) occasionally occurs, and has varying clinical significance based upon amount of bleeding. Hemoptysis resulting in a clot and airway obstruction is an extremely rare event found almost exclusively in the intensive care unit. We describe a unique case of hemoptysis resulting in bronchial impaction from a clot requiring an emergent return to CPB during valve replacement surgery. We used a rigid bronchoscope, without an endotracheal tube, to facilitate airway patency in a patient with diffuse airway bleeding after bronchial disimpaction to separate from CPB.
Department of Anesthesiology, Langone New York University Medical Center, NY 10016, USA.
Peter J
PJ
Neuburger
Aubrey C
AC
Galloway
Michael D
MD
Zervos
Marc S
MS
Kanchuger
D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000295:instrumentation*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D012121:Respiration, Artificial; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome