Villagrana-Márquez SA

Language: Spanish
References: 10
Page: 349-352
PDF size: 244.16 Kb.

ABSTRACT

Introduction: the medical management of massive air leak is often challenging, particularly when damage occurs in both main bronchi. An alternative strategy is to employ asynchronous mechanical ventilation (using two ventilators) to attempt to surpass or even splint the bronchial injury provisionally with a double-lumen endotracheal tube for subsequent surgical resolution. Case report: we present a clinical case of a patient with massive air leak due to injury in both secondary bronchi resulting from descending necrotizing mediastinitis caused by Staphylococcus aureus. Selective intubation with a double-lumen tube and independent ventilation using two ventilators asynchronously was implemented. This ventilation approach involves both anatomical and physiological separation, along with the adjustment of different parameters for each lung. Common indications for this type of ventilation include pneumonia-induced lung injury, massive air leak from bronchopleural fistula, pulmonary hemorrhage, and pulmonary contusion. Conclusion: asynchronous ventilation can provide the necessary lung protection for the patient and effectively manage PaCO₂ levels without the use of ECMO.

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