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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
CLINICAL CASES RESUSCITATION
Minerva Anestesiologica 2006 July-August;72(7-8):665-74
language: English, Italian
Bilateral concurrent massive hemoptysis successfully controlled with double endobronchial tamponade. A case report
Giannoni S., Buti G., Allori O., Conti D., Ferri L.
Anesthesia and Intensive Care Unit S. Giuseppe Hospital, AUSL 11 Empoli (Florence), Italy
Massive hemoptysis is a potentially lethal situation for which emergency diagnosis and treatment are necessary. Endobronchial tamponade is widely used as a method for conservative management of massive hemoptysis by occluding the bleeding bronchus with a balloon catheter. Some baloon catheters can be introduced through the inner channel of a flexible bronchoscope. The main challenge in performing this procedure is how to remove the bronchoscope without displacing the catheter. Another techique is to place a catheter next to the fiberoptic bronchoscope and then advance the catheter to the hemorrhaging bronchial division. An advantage of this “parallel technique” is that the working channel is available for suction, lavage and for a biopsy forceps, that can be used to facilitate the posizioning of the catheter. We used this technique to perform bilateral endobronchial tamponade with two 5 Fr Swan-Ganz catheters. This case shows that bilateral concurrent massive hemoptysis can be succesfully controlled with the placement of more than one balloon cathe-ter.This is a rare event and in the literature we found only one reference. The procedure was relatively easy to perform and well tolerated by the patient. In our opinion, this technique should be considered as a viable option in the treatment of massive hemoptysis especially in hospitals or patients where other treatments are impossible or contraindicated.