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(Chest. 2001;120:1399-1402.)
© 2001 American College of Chest Physicians

First Experience With Fiberoptically Directed Wire-Guided Endobronchial Blockade in Severe Pulmonary Bleeding in an Emergency Setting*

Barbara Kabon, MD; Barbara Waltl, MD; Johannes Leitgeb, MD; Stephan Kapral, MD and Michael Zimpfer, MD

* From the Department of Anesthesiology and General Intensive Care (Drs. Kabon, Waltl, Kapral, and Zimpfer) and the Department of Traumatology (Dr. Leitgeb), University of Vienna, Austria.

Correspondence to: Barbara Kabon, MD, Department of Anesthesiology and General Intensive Care, University Hospital of Vienna, 18–20 Waehringer Guertel, A-1090 Vienna, Austria; e-mail: barbara.kabon{at}univie.ac.at

We report the first use of a new wire-guided endobronchial blocker in a critical respiratory situation caused by localized pulmonary bleeding. During emergency management, it became increasingly difficult to ventilate a multiple-trauma patient with a conventional single-lumen tube because of massive bleeding through the bronchus of the left lower lobe. Using the Arndt endobronchial blocker set (William Cook Europe A/S; Bjaeverskor, Denmark), we were able to prevent the spread of hemorrhaging and achieved effective ventilation and marked improvement in gas exchange. This new device allows the effective blockade of an isolated lobe under direct bronchoscopy to buy time for further intervention.

Key Words: blockade of segmental bronchus • blunt thoracic trauma • intrabronchial hemorrhage • wire-guided endobronchial blocker




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