title: Anesthetic management of bronchial rupture following extraction of a fishbone from the bronchus after 5 months.
abstract: Bronchial rupture occurred during bronchoscopic visualization and extraction of a fishbone from the bronchus in a 2-year-old male patient with a 5-month history of foreign body aspiration. Emergency thoracotomy was scheduled for examination and surgical repair of the bronchus. The pressure of the airway and circuit fell sharply and ventilation could not be maintained after muscle relaxants were injected and spontaneous respiration ceased. Oxygenation worsened rapidly with the peripheral oxygen saturation level decreasing below 60%. An endotracheal tube was inserted into one of the main bronchi. Peripheral oxygen saturation improved from 60% to 90%, and subsequent surgery was performed without complications.
authors.affiliation: Department of Anesthesiology, Pudong New Area Zhoupu Hospital, Shanghai, China.
authors.forename: Guoping
authors.initials: G
authors.lastname: Ma
authors.forename: Jingli
authors.initials: J
authors.lastname: Yang
authors.forename: Song
authors.initials: S
authors.lastname: Liu
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D000777:Anesthetics; D018686:Anesthetics, Intravenous; D001980:Bronchi / Q000293:injuries* / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods; D002675:Child, Preschool; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use; D015742:Propofol; D012121:Respiration, Artificial / Q000379:methods; D012421:Rupture; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome; D014673:Vecuronium Bromide / Q000627:therapeutic use*
chemical_list: D000700:Analgesics; D000777:Anesthetics; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D007649:Ketamine; D014673:Vecuronium Bromide; D015742:Propofol
keywords: anesthesia induction; bronchial rupture; endobronchial intubation; muscle relaxant; positive pressure ventilation; spontaneous ventilation