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Intraoperative contralateral tension pneumothorax during pneumonectomy
Gordon N Finlayson1, Albert B Chiang, Jay B Brodsky
1Department of Anesthesia, Stanford University School of Medicine, Stanford, California, USA.
Anesthesia and Analgesia
|January 1, 2008
Summary
Unrecognized tension pneumothorax can be fatal. This case highlights that high inspiratory pressures during surgery may indicate this condition, even without typical low oxygen or blood pressure symptoms.
Area of Science:
- Medicine
- Surgery
- Pulmonology
Background:
- Tension pneumothorax is a life-threatening condition.
- It typically presents with hypoxemia and hemodynamic instability.
Observation:
- A patient undergoing thoracotomy developed contralateral tension pneumothorax.
- This occurred without the classic signs of marked hypoxemia and hemodynamic instability.
Findings:
- High peak inspiratory pressures during one-lung ventilation with an open chest can indicate tension pneumothorax.
- Classic signs may be absent in some cases.
Implications:
- Clinicians should consider tension pneumothorax in patients with high inspiratory pressures during thoracic surgery.
- Early recognition and intervention are crucial to prevent catastrophic outcomes.
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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
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Clinical Manifestations:
Clinical Manifestations:
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