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Keywords:

  • barotrauma;
  • fiberoptic intubation;
  • left main-stem intubation;
  • respiratory distress syndrome;
  • selective bronchial intubation;
  • single-lung ventilation

Abstract

A 24-week premature infant developed severe right-sided pulmonary barotrauma secondary to mechanical ventilation for respiratory distress syndrome (RDS). High-frequency oscillatory ventilation and permissive hypercapnia were initiated. A chest tube was placed to relieve a pneumothorax, and a catheter was inserted into an air-filled cyst for drainage. These maneuvers failed to improve the child's respiratory status.

The child's left main-stem bronchus was then successfully fiberoptically intubated for single-lung ventilation in order to reduce the unilateral barotrauma. Single-lung ventilation was effectively and safely continued for 5 days, with complete resolution of the pulmonary barotrauma. Pediatr Pulmonol. 2002; 33:227–231. © 2002 Wiley-Liss, Inc.