Intraoperative ventilation strategy in a patient with empyema thoracis complicated by bronchopleural fistula

Bhattacharya, Soma; Dubey, Prakash K.; Kumari, Rupam

doi:10.4103/1687-9090.200284

Intraoperative ventilation strategy in a patient with empyema thoracis complicated by bronchopleural fistula

Authors

10.4103/1687-9090.200284

Abstract

Bronchopleural fistulae (BPF) are communications between the bronchioles of the respiratory tract and pleural space. No consensus has been established for the management of BPF due to varied presentation. We report the successful use of one lung ventilation with left sided double lumen tube in a patient with BPF following recurrent thoracic empyema, posted for decortications & repair under general anaesthesia. This case was unique as the patient had restrictive lung disease on the left side due to fibrosis of pleural space and mediastinum following tuberculosis. There were features of obstructive lung disease on the right side due to compensatory emphysema. We had to work up an individualised ventilatory strategy focussed on the better lung to cater to the unique need of our patient that turned out to be safe & effective. Lung protective ventilatory strategy along with proper postoperative management helped in early recovery of the patient.

Keywords