Pulmonary Artery Rupture Management with a Single Lumen Endotracheal Tube: Old Tricks that Should be Revisited
Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care
Thanuja Neerukonda, William J. Gibson, Travis Abicht, Andrew Sauer, Brigid C. Flynn
School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
Am J Case Rep 2018; 19:342-346
Pulmonary artery rupture can be a lethal complication of a pulmonary artery catheter (PAC). Different techniques have been used to manage PAC-induced pulmonary artery rupture, including double lumen endotracheal tube (DLT), bronchial blockers, pulmonary artery embolization, thoracotomy with hematoma evacuation, and extracorporeal life support for ventilation (ECLS). Single lumen endotracheal tube (ETT) is not frequently reported in the literature despite its advantages.
CASE REPORT: The authors present a case of PAC-induced pulmonary artery rupture successfully managed with a single lumen ETT. Although single lumen ETT is more labor intensive and requires constant critical care attention, the advantages of this technique are reported in this case in comparison to other well-documented therapies.
CONCLUSIONS: With on-going pulmonary bleeding, a single lumen ETT intubation offers advantages to the commonly advocated methods of treating a PAC-induced pulmonary artery rupture.
Keywords: Bronchoscopes, Catheterization, Swan-Ganz, Critical Care, Hemoptysis