• A&A practice · Dec 2020

    Case Reports

    High-Frequency Jet Ventilation for a Patient With Tracheomediastinal Fistula, Tension Pneumomediastinum, and Pneumothorax: A Case Report.

    • Chi Ho Chan, Elizabeth S J Tan, Kenny W T Loh, and Sharon G K Ong.
    • From the Departments of Anesthesiology.
    • A A Pract. 2020 Dec 17; 14 (14): e01362.

    AbstractTracheomediastinal fistula (TMF) is an uncommon condition and carries a high mortality. We report the anesthetic management of a patient with TMF using stent insertion via rigid bronchoscopy. The TMF was a complication of double-lumen endotracheal tube insertion resulting in a tension pneumomediastinum. Initial intraoperative attempts to ventilate the lungs and overcome the air leak with high gas flow of 45 L/min via the side port of the bronchoscope resulted in a pneumothorax. This case report demonstrates that high-frequency jet ventilation can minimize the air leak and avoid barotrauma during anesthesia for TMF repair.Copyright © 2020 International Anesthesia Research Society.

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