Bedside placement of an endobronchial valve to aid invasive ventilation and weaning from extracorporeal membrane oxygenation.
A bronchopleural fistula (BPF) is a life-threatening complication of cardiothoracic surgery and acute illness. There is no consensus on how best to treat a BPF. Recently, endobronchial one-way valves, designed for bronchoscopic lung volume reduction in emphysema, have been used to treat BPFs. We describe the use of an endobronchial oneway valve, placed at the bedside via flexible bronchoscopy, to treat a BPF in a patient with hypoxic respiratory failure, supported by extracorporeal membrane oxygenation (ECMO), secondary to pneumonia. We believe that this is the first published description of this technique being used in a patient needing ECMO support.
Intensive Care Unit, The Alfred, Melbourne, Australia. MGillham@adhb.govt.nz.
Aidan M
AM
Hodges
Auckland City Hospital, Auckland, New Zealand.
Michael J
MJ
Gillham
Auckland City Hospital, Auckland, New Zealand.
Christopher A
CA
Lewis
D000293:Adolescent; D001983:Bronchial Fistula / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy; D015199:Extracorporeal Membrane Oxygenation; D005674:Fusobacterium Infections / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005675:Fusobacterium necrophorum; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008297:Male; D010995:Pleural Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D018410:Pneumonia, Bacterial / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D019095:Point-of-Care Systems; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy