Journal List > Tuberc Respir Dis > v.72(2) > 1001722

Moon, Lee, Lyu, Huh, Hong, Kim, Lim, and Koh: Massive Hemoptysis Cases Intubated with the Univent® Bronchial Blocker for Lung Protection

Abstract

Massive hemoptysis is a life-threatening condition and sometimes leads to death due to airway obstruction rather than exsanguinations. In a critical hemoptysis, endotracheal intubation may be necessary to maintain adequate gas exchange and protect the unaffected side of the lung. Bronchial blockers (BBs), commonly used technique for one-lung ventilation in thoracic or cardiac surgeries, are valuable devices for protecting the airway in massive endobronchial bleeding. We report three cases intubated with BBs, Univent®, in massive hemoptysis. We suggest that BBs are one of the indispensable equipments for respiratory specialized wards and intensive care units.

Figures and Tables

Figure 1
Univent® torque control blocker (Fuji Systems Corporation, Tokyo, Japan).
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Figure 2
A 67-year-old woman with aplastic anemia manifesting fever and pancytopenia. Physicians diagnosed fungal infection and NTM disease in the immunocompromised host (A~C). After hospitalization, massive hemoptysis from RML was confirmed by bronchoscope, she was intubated with Univent® torque control blocker (D, E, black arrow). Fifty days later, she was discharged (F). RML: right middle lobe; NTM: Non-tuberculous mycobacteria.
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Figure 3
A 74-year-old man visited the emergency room and started to coughing up blood. Chest x-ray and chest computed tomography scan revealed reactivation of pulmonary tuberculosis and Rasmussen aneurysm (A~C). Hypoxemia deteriorated rapidly, and he was intubated with Univent® blocker (D, E, black arrow). He received treatment for bronchial artery embolization, and recovered from total atelectasis of the right lung three days later (F).
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Figure 4
A 62-year-old man with NSCLC was hospitalized for pneumonia (A). Next day, he was treated with BAE due to recurrent hemoptysis. However, a life- threatening hemoptysis ocurred. After being intubated with Univent® blocker, it followed stopped bleeding. Chest computed tomography images showed necrotizing pneumonia in the left hemithorax (B). NSCLC: non-small cell lung cancer; BAE: bronchial artery embolization.
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Acknowledgements

I am grateful to our intensive care unit nurses and an operating unit nurse of thoracic surgery for helping us taking pictures of the devices.

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