Abstract
Hydropneumothorax is an uncommon but potentially fatal complication for a patient undergoing positive pressure ventilation. The case of a 23-year-old woman with severe asthma requiring lung lavage is described. Twenty minutes after an uneventful left lung lavage, the patient experienced increased peak airway pressure, decreased oxygen saturation and hypercarbia, despite ventilation with 90 per cent oxygen. A chest x-ray revealed mediastinal shift and a left sided pneumothorax. Drainage was carried out, revealing air and clear fluid in the pleural space. The importance of technical problems such as patient and endotracheal tube positioning, elimination of cross-spilling and cardiopulmonary effects of lavage are discussed.
Résumé
L’hydropneumothorax est une complication peu fréquente mais potentiellement fatale pour un patient ventilé à pression positive. Le cas d’une femme de 23 ans présentant un asthme sévère el devant subir un lavage pulmonaire est décrit. Vingt minutes après un lavage du poumon gauche sans accident, la patiente présenta une augmentation de la pression des voies aériennes, une diminution de la saturation en oxygène et une hypercarbie malgré une ventilation à 90 per cent d’oxygène. Le rayon-x révéla un déplacement médiastinal et un pneumothorax gauche. Le drainage effectué a démontre la présence d’air et de liquide clair dans l’espace pleural. L’importance des problèmes techniques tels que le positionnement de la patiente et du tube endotrachéal, l’élimination du “cross-spilling” ainsi que les effets cardiopulmonaires du lavage sont discutés.
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Hudes, E.T., Bradley, J.W. & Brebner, J. Hydropneumothorax- an unusual complication of lung lavage. Can Anaesth Soc J 33, 662–665 (1986). https://doi.org/10.1007/BF03014274
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DOI: https://doi.org/10.1007/BF03014274