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

Tuberculosis and Respiratory Diseases 2012; 72(2): 212-217.

Published online: 29 February 2012

DOI: https://doi.org/10.4046/trd.2012.72.2.212

Massive Hemoptysis Cases Intubated with the Univent® Bronchial Blocker for Lung Protection

Jae Young Moon, M.D.1, Young Seok Lee, M.D.1, Jiwon Lyu, M.D.1, Jin Won Huh, M.D., Ph.D.1, Sang Bum Hong, M.D., Ph.D.1, Sang-We Kim, M.D., Ph.D.2, Chae-Man Lim, M.D., Ph.D.1, YounSuck Koh, M.D., Ph.D.1

1Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

2Department of Internal Medicine, Division of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: YounSuck Koh, M.D., Ph.D. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-dong, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-4700, Fax: 82-2-3010-4709, yskoh@amc.seoul.kr

Received 26 December 2011       Revised 2 January 2012       Accepted 18 January 2012

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

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.

Keywords: Hemoptysis, Intubation, Airway management, instrumentation

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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