• Paediatric anaesthesia · Jun 2003

    Case Reports

    Life threatening unilateral pulmonary overinflation might be more successfully treated by contralateral selective intubation than by emergency pneumonectomy.

    • Josef Holzki and Max Kellner.
    • Departments of Paediatric Anaesthesia and Surgical Paediatric Intensive Care and Paediatric Radiology, Children's Hospital, Kliniken der Stadt Köln, Germany. josef.holzki@arcor.de
    • Paediatr Anaesth. 2003 Jun 1; 13 (5): 432-7.

    AbstractDuring a period of 3 years, three infants were admitted to our hospital for unilateral emergency pneumonectomy due to life threatening overinflation of one lung, preventing adequate ventilation of the unaffected contralateral side. All three patients were able to be stabilized by unilateral selective bronchial intubation of the unaffected lung after bronchoscopy, ruling out a flap valve mechanism. No emergency pneumonectomies were required. In one patient, lung function of the overinflated side (three lobes) recovered fully and, in the two remaining patients, one lobe of the overinflated side recovered. The overinflated lobes were removed later by elective surgery, thus not exposing the children to a potentially dangerous emergency operation. These results are in contrast with reports in the literature. Emergency pneumonectomy in neonates and infants due to overinflation of one lung may be avoided by selective unilateral intubation of the main stem bronchus of the compressed lung.

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