Zhou C, Song S, Fu JF, Zhao XL, Liu HQ, Pei HS, Guo HB. Continuous positive airway pressure for treating hypoxemia due to pulmonary vein injury: A case report. World J Clin Cases 2023; 11(8): 1830-1836 [PMID: 36969990 DOI: 10.12998/wjcc.v11.i8.1830]
Corresponding Author of This Article
Jian-Feng Fu, MS, Chief Physician, Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang 050011, Hebei Province, China. fffjf2008@sohu.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Chao Zhou, Jian-Feng Fu, Xue-Lian Zhao, Hua-Qin Liu, Huan-Shuang Pei, Hong-Bo Guo, Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050001, Hebei Province, China
Shan Song, Department of Respiratory, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
Author contributions: Zhou C and Guo HB wrote the manuscript; Song S finished the literature review; Zhao XL, Liu HQ provided revision suggestions; Pei HS contributed to the redaction of this manuscript and proof reading; Fu JF contributed to manuscript finalizing.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Feng Fu, MS, Chief Physician, Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang 050011, Hebei Province, China. fffjf2008@sohu.com
Received: December 15, 2022 Peer-review started: December 15, 2022 First decision: January 17, 2023 Revised: February 25, 2023 Accepted: February 22, 2023 Article in press: February 22, 2023 Published online: March 16, 2023
Abstract
BACKGROUND
Vascular injury during thoracoscopic surgery for esophageal cancer is a rare but life-threatening complication that can lead to severe hypotension and hypoxemia. Anesthesiologists need to provide rapid and effective treatment to save patients' lives.
CASE SUMMARY
A 54-year-old male patient was scheduled to undergo a thoracoscopic-assisted radical resection of esophageal cancer through the upper abdomen and right chest. While dissociating the esophagus from the carina through the right chest, unexpected profuse bleeding occurred from a suspected pulmonary vascular hemorrhage. While the surgeon attempted to achieve hemostasis, the patient developed severe hypoxemia. The anesthesiologist implemented continuous positive airway pressure (CPAP) using a bronchial blocker (BB), which effectively improved the patient’s oxygenation and the operation was completed successfully.
CONCLUSION
CPAP using a BB can resolve severe hypoxemia caused by accidental injury of the left inferior pulmonary vein during surgery.
Core Tip: Although hypoxemia caused by pulmonary vein injury is a rare complication, it is life-threatening. We report such a rare case, successfully managed by continuous positive airway pressure using a bronchial blocker. We hope that this case report helps other specialists to promptly manage similar incidents and avoid treatment delays and death.
