Chang Gung medical journal
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Tension pneumothorax is not a rare complication of mechanical ventilation, but its occurrence immediately after intubation with a double-lumen endotracheal tube (DLT) is very rare. Subsequent impairment of the respiratory and cardiovascular function can be life threatening if it is not detected early enough and managed properly. ⋯ Herein we report a case of tension pneumothorax and pneumoperitoneum which occurred immediately after DLT intubation. It appeared before one-lung ventilation was applied because of an inappropriately small-sized and malpositioned DLT.
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Case Reports
Profound hypoxemia during major abdominal surgery in a small infant with tetralogy of Fallot.
We report a protracted hypoxic event during Soave's endorectal pull-through for Hirschsprung's disease in a 2-month-old male infant with tetralogy of Fallot. After the bowel loops were delivered out of the abdominal cavity, profound hypoxemia occurred which persisted for about 120 min. The hypoxemia was completely resolved after the intestine was reduced back into the peritoneal cavity. ⋯ Associated factors included hypothermia and acidosis leading to high pulmonary vascular resistance which further aggravated the right-to-left blood-shunting situation in this patient. Postoperative follow-up showed no neurological complications. Small infants with complex heart disease should be carefully evaluated before major abdominal surgery.