title: High-frequency jet ventilation using the Arndt bronchial blocker for refractory hypoxemia during one-lung ventilation in a myasthenic patient with asthma.
abstract: A novel method in the management of refractory severe hypoxemia during one-lung ventilation (OLV) in a patient who presented with myasthenia gravis, asthma, a symptomatic mediastinal mass, hiatal hernia, and a moderate pericardial effusion is presented. The patient was scheduled for excision of a large anterior mediastinal mass and creation of a pericardial window through a left thoracotomy. One-lung ventilation was achieved using an Arndt bronchial blocker. High-frequency jet ventilation (HFJV) was applied to the surgical nondependent lung through the lumen of the Arndt endobronchial blocker with titration of positive end-expiratory pressure to the dependent lung. Oxygenation improved significantly. The use of HFJV through the Arndt blocker offers an effective method for treatment of refractory hypoxemia during OLV.
authors.affiliation: Department of Anesthesiology, King Fahd Hospital of the University of Dammam, Dammam, Saudi Arabia, P.O. 40289, Al Khubar 31952, Saudi Arabia. Electronic address: mohamedrefaateltahan@yahoo.com.
authors.forename: Mohamed R
authors.initials: MR
authors.lastname: El-Tahan
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic, 9500 Euclid Ave., E31, Cleveland, OH 44195, USA.
authors.forename: D John
authors.initials: DJ
authors.lastname: Doyle
authors.affiliation: Department of Anesthesiology, King Fahd Hospital of the University of Dammam, Dammam, Saudi Arabia, P.O. 40289, Al Khubar 31952, Saudi Arabia.
authors.forename: Ahmed G
authors.initials: AG
authors.lastname: Hassieb
mesh_terms: D000368:Aged; D001249:Asthma / Q000150:complications*; D005260:Female; D006611:High-Frequency Jet Ventilation / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy*; D009157:Myasthenia Gravis / Q000150:complications*; D061810:One-Lung Ventilation / Q000295:instrumentation* / Q000379:methods
keywords: Arndt bronchial blocker; High-frequency jet ventilation; Hypoxemia; Myasthenia gravis; One-lung ventilation; Ventilation