Korean J Anesthesiol.  1990 Feb;23(1):95-99. 10.4097/kjae.1990.23.1.95.

Tension Pneumothorax Developed during the Use of Jackson - Rees Modification System with Ayre's T-Piece

• Jeon YJ
• Shin KM
• Kang WJ
• Kim DS
• Shin KI

• KMID: 1933743
• DOI: http://doi.org/10.4097/kjae.1990.23.1.95

Abstract

Pneumothorax was recognized as a potential hazard of mechanical ventilation during anesthesia. Because the gases used in anesthesia are delivered from cylinder and wall outlets at higher than atmospheric Pressure, the possibility of damage to the lung is over present. Alveolar rupture may occur when there is free transmission of high pressure to the alveoli during tracheal intubation at the start of anesthesia. We had a case of tension pneumothorax developed during the use of Jackson-Rees modification with Ayres T-piece for primary closure of laceration on right hand in 4 years old child under general anesthesia. The patient was presented of acute respiratory distress resulting from pneumothorax and subcutaneous emphysema just after tracheal intubation. The tension pneumothorax was noticed on chest X-ray. This complication was the result of undesirable alveolar ventilation with high fresh gas flow by accidental using of oxygen flush valve. With the prompt decision of diagnosis of tension pneumothorax and aggresive treatment, the patient recovered uneventfully and discharged 7 days later.

Keyword

Tension pneumothorax; Alveolar rupture; High fresh gas flow; Oxygen flush valve

MeSH Terms

Anesthesia
Anesthesia, General
Atmospheric Pressure
Child
Child, Preschool
Diagnosis
Gases
Hand
Humans
Intubation
Lacerations
Lung
Oxygen
Pneumothorax*
Respiration, Artificial
Rupture
Subcutaneous Emphysema
Thorax
Ventilation
Gases
Oxygen