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Endobronchial blood-patch: A novel technique for a persistent pleural air leak.
Durrance, Richard J; D'Souza, Kenneth G; Obata, Reiichiro; Bradley, Ellen C; Perwaiz, Muhammad K.
Afiliação
  • Durrance RJ; Pulmonary-Critical Care Fellow. Icahn School of Medicine at Mount Sinai, Elmhurst Hospital, United States.
  • D'Souza KG; Pulmonary-Critical Care Fellow. Icahn School of Medicine at Mount Sinai, Elmhurst Hospital, United States.
  • Obata R; Pulmonary-Critical Care Fellow. Icahn School of Medicine at Mount Sinai, Elmhurst Hospital, United States.
  • Bradley EC; Pulmonary-Critical Care Fellow. Icahn School of Medicine at Mount Sinai, Elmhurst Hospital, United States.
  • Perwaiz MK; Interventional Pulmonology and Pulmonary Critical Care Attending, Icahn School of Medicine at Mount Sinai: Elmhurst Hospital, United States.
Respir Med Case Rep ; 38: 101670, 2022.
Article em En | MEDLINE | ID: mdl-35656093
Introduction: Patients with severe COVID-19 Pneumonia requiring prolonged mechanical ventilation have an increased incidence of pneumothorax. Mechanically ventilated patients who are critically ill and develop a persistent air leak from pneumothorax are poor candidates for surgical repair. As the persistent air leak can be a significant barrier to vent-weaning and clinical stability, these patients present a unique clinical challenge. Clinical case: A 65-year-old male intubated and on prolonged mechanical ventilation for severe COVID-19 Pneumonia developed a pneumothorax complicated by a persistent alveolar-pleural fistula with a persistent air-leak. Given his critical state with ongoing pressor requirements and elevated vent requirements, surgical repair was not an option. A bedside bronchoscopy occlusion study with isolation of the air leak, and subsequent autologous endobronchial blood-patch repair with thrombin was performed with rapid and definitive resolution of the air leak. The patient progressed favorably, ultimately being weaned from the ventilator, decannulated, and walking out of the hospital. Conclusion: In critically ill ventilated patients with pneumothorax complicated by a persistent air-leak, bedside endobronchial evaluation and blood-patch repair is a feasible approach to management.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2022 Tipo de documento: Article