Bronchopleural Fistula

Abstract

Bronchopleural fistula (BPF) is a pathological communication between bronchial tree and pleural space. BPF has multiple etiologies but postsurgical ones carry the highest incidence and the worst prognosis. Diagnosis is based on the clinical presentation and confirmation with radiological imaging (chest X-ray, computed tomography scan) or bronchoscopy. Management of BPF involves a combination of surgical procedures, medical therapy and diagnostic and therapeutic bronchoscopy. Anesthetic considerations and management focus in perioperative optimization of intravascular volume status, proper and careful isolation of the affected lung to avoid spillage of contaminated material into the unaffected lung, and assurance of proper ventilation (either by conventional or special ventilatory techniques) during and after the operation.