Jacobs Journal of Anesthesiology and Research

A Unique Technique of External Chest Compressions Synchronised with Suction to Clear an Occluded Main Bronchus

*Saad Gomaa
Department Of Anesthesiology, Hinchingbrooke Hospita, Cambridgeshire, United Kingdom

*Corresponding Author:
Saad Gomaa
Department Of Anesthesiology, Hinchingbrooke Hospita, Cambridgeshire, United Kingdom
Email:smgomaa@hotmail.com

Published on: 2015-10-26

Abstract

Both positive pressure ventilation via endotracheal intubation and non-invasive ventilation are established modes of ventilation support for the treatment of respiratory failure. The choice depends on the overall clinical status of the patient. The British Thoracic Society has set criteria for the choice and application of non-invasive ventilation in 2002. The application of Bi-level Positive Airway Pressure (BiPAP) as a mode of ventilation support is an effective and popular option. However, there are numerous complications associated with these techniques. This case report describes an unreported rare complication during BiPAP supportive ventilation where the left main bronchus was occluded with blood clots, and the application of a unique technique to clear the obstructed bronchus in order to restore effective ventilation to that lung.

Keywords

Haemoptysis; Acute respiratory failure; Lung collapse; BiPAP; Cardiac arrest; Resuscitation; Bronchial Obstruction; Bronchoscopy

Introduction

An 82 years old lady presented to the Emergency Department (ED) with severe shortness of breath, frequent coughing, episodes of haemoptysis and air hunger. Her past medical history revealed that she is an ex-smoker, suffering from hypertension and Parkinsonism that were both well controlled by medication. Over the preceding few years she had progressively lost weight, although this had settled at 40 kg for the last two years. Regular medical consultations, laboratory tests and a CT scan of her chest and abdomen two years previously were all clear. However, the CT did show hyperinflation of the lungs and she was diagnosed with mild emphysema; there was no history of asthma or chronic obstructive airway disease.