Anesthetic Management of a Case of Airway Bleeding During Pulmonary Artery Mass Resection

Abstract

Airway bleeding is an uncommon complication of pulmonary artery surgery. It can be caused by fragile bronchopulmonary collateral, vessel perforation, and reperfusion pulmonary edema. Early discovery of the breach and anesthetic management are very important for the prognosis of the patients. We present a case of 58-year-old female diagnosed with left pulmonary artery mass. After the resection of the mass, the surgeon injected saline into the pulmonary artery and the patient was ventilated manually. Air bubbles were found in the artery, indicating a breach between the airways and the pulmonary circulation. Fiberoptic bronchoscopy revealed the breach on the lateral wall of the left lower bronchus. We replaced the single lumen endotracheal tube with a 32 left-sided double-lumen endobronchial tube to prevent the contamination of the right lung. After a consultation with the thoracic department, left lower lung lobectomy was performed.