Chest
Treatment for Collapsed Lung in Critically III Patients: Selective Intrabronchial Air Insufflation Using the Fiberoptic Bronchoscope
Section snippets
MATERIALS AND METHODS
Twelve patients were admitted to the medical or surgical ICU for the different critical conditions (Table 1). The duration of lung collapse ranged from 24 to 120 hours. All had received intensive respiratory care since admission to prevent atelectasis. When the lung collapsed, another 24 hours of respiratory therapy was performed before the fiberoptic bronchoscopic procedure.
A fiberoptic bronchoscope was used. A three-way adaptor was connected to the suction channel of the bronchoscope. One
RESULTS
After 12 of the 14 procedures, the chest x-ray film showed complete reexpansion; in the remaining two, case 5 and the secondary procedure in case 12, the x-ray film showed partial re-expansion. In case 5 the collapsed lung reexpanded completely after six days of continuous, intensive, pulmonary care. In case 12, a third bronchoscopic procedure was performed with immediate full re-expansion (Table 1).
Case 1 and case 6 died of septic shock 24 and 26 hours after the bronchoscopic procedure. Their
DISCUSSION
Collapsed lung is one of the important problems in critically ill patients, and the clinical condition may worsen rapidly. Treatment with a therapeutic fiberoptic bronchoscopic procedure at the bedside was introduced and good results were reported in many studies.6, 7, 8, 9 This therapeutic procedure includes repetitive sputum suctioning and bronchial washing with normal saline solution; complete or partial re-expansion of atelectasis was attained in 60 to 90 percent of the cases.1, 6, 7, 8, 9,
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Manuscript received February 28; revision accepted July 6.