Dependent Lung Tension Pneumothorax During 1-Lung Ventilation: Treatment by Transmediastinal Thoracentesis.
Contralateral tension pneumothorax during 1-lung ventilation is rare but life threatening. We report the case of a patient who developed tension pneumothorax of the dependent lung during 1-lung ventilation while the surgeon was anastomosing the bronchi after sleeve lobectomy. Ventilation was not possible in either the dependent or nondependent lung, leading to severe desaturation and cardiac arrest. While the surgeons were administering direct cardiac compression, we suspected tension pneumothorax. As soon as the surgeons pierced the mediastinal pleura, adequate circulation was restored. Immediate diagnosis and treatment is important for this complication.
From the Departments of *Anesthesiology and Intensive Care Medicine, and †General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Okitsu
O
Kenta
Arimoto
A
Shoko
Iritakenishi
I
Takeshi
Hagihira
H
Satoshi
Fujino
F
Yuji
Shintani
S
Yasushi
Minami
M
Masato
Okumura
O
Meinoshin
D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006336:Heart Massage / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D061810:One-Lung Ventilation / Q000009:adverse effects*; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D000069258:Thoracentesis / Q000379:methods*