- CPR/Resuscitation
-
Fatal airway obstruction due to a ball-valve clot with identical signs of tension pneumothorax
-
Hisaaki Munakata, Michiko Higashi, Takahiro Tamura, Yushi Ueda Adachi
-
Acute Crit Care. 2020;35(4):298-301. Published online April 20, 2020
-
DOI: https://doi.org/10.4266/acc.2019.00570
-
-
7,021
View
-
156
Download
-
4
Web of Science
-
4
Crossref
-
 Abstract
 PDF
- Endo-tracheal tube obstruction due to an extensive blood clot is a recognized but very rare complication. A ball-valve obstruction in the airway could function as a check valve for the lung and thorax, resulting in tension pneumothorax-like abnormalities. A 47-year-old female patient had undergone implantation of a left ventricular assist device 3 weeks prior. On post-operative day 17, planned thoracentesis was performed for drainage of a pleural effusion. Despite the drainage, the patient’s oxygenation did not improve, and emergency tracheal intubation was conducted. Subsequent computed tomography revealed bilateral pneumothorax. Two days later, the patient’s trachea was extubated without complication, and a mini-tracheostomy tube was placed. Three hours later, reintubation was conducted due to progressive tachypnea. Although successful intubation was confirmed, ventilation became increasingly difficult and finally impossible. Marked increase in pulmonary artery and central venous pressures suggested progression of the previous tension pneumothorax. After emergency extracorporeal membrane oxygenation was initiated, fiberoptic bronchoscopy revealed the presence of a massive clot and ball-valve obstruction of the endotracheal tube. Two weeks later, the patient died due to severe hypoxic brain damage. Diagnosis of ball valve clot is not simple, but intensivists should consider this rare complication.
-
Citations
Citations to this article as recorded by  - Extracorporeal membrane oxygenation in critical airway interventional therapy: A review
Hongxia Wu, Kaiquan Zhuo, Deyun Cheng
Frontiers in Oncology.2023;[Epub] CrossRef - Endobronchial hydatid cyst causing variable intrathoracic airflow limitation selectively during expiration acting as a ball valve
Pavan Kumar Dammalapati, Sandeep Kumar Kar, Chaitali Sen Dasgupta
Indian Journal of Thoracic and Cardiovascular Surgery.2023; 39(4): 438. CrossRef - In reply: Non-ventilated lung airway occlusion during one-lung ventilation: a need for further research?
Jacques Somma, Edouard Marques, Jean S. Bussières
Canadian Journal of Anesthesia/Journal canadien d'anesthésie.2021; 68(9): 1458. CrossRef - A case of haemoptysis and bilateral areas of lung consolidation sparing the right lower lobe
Nadia Corcione, Antonio Ponticiello, Severo Campione, Alfonso Pecoraro, Livio Moccia, Giuseppe Failla
Breathe.2021; 17(4): 210072. CrossRef
|
KSCCM
