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High-frequency jet ventilation using the Arndt bronchial blocker for refractory hypoxemia during one-lung ventilation
Mohamed R El-Tahan1, D John Doyle2, Ahmed G Hassieb1
1Department of Anesthesiology, King Fahd Hospital of the University of Dammam, Dammam, Saudi Arabia, P.O. 40289, Al Khubar 31952, Saudi Arabia.
Abstract:
A novel method in the management of refractory severe hypoxemia during one-lung ventilation (OLV) in a patient who presented with myasthenia gravis, asthma, a symptomatic mediastinal mass, hiatal hernia, and a moderate pericardial effusion is presented. The patient was scheduled for excision of a large anterior mediastinal mass and creation of a pericardial window through a left thoracotomy. One-lung ventilation was achieved using an Arndt bronchial blocker. High-frequency jet ventilation (HFJV) was applied to the surgical nondependent lung through the lumen of the Arndt endobronchial blocker with titration of positive end-expiratory pressure to the dependent lung. Oxygenation improved significantly. The use of HFJV through the Arndt blocker offers an effective method for treatment of refractory hypoxemia during OLV.
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