Korean J Anesthesiol.  1995 May;28(5):722-727. 10.4097/kjae.1995.28.5.722.

Acute Attack of Asthma and Pulmonary Collapse Induced by Tracheal Intubation

• Kim SW
• Kim JG
• Lee JS
• Kwon BY

• KMID: 2033174
• DOI: http://doi.org/10.4097/kjae.1995.28.5.722

Abstract

Identification of the presence of chronic obstructive pulmonary disease in the elderly patient who was scheduled for surgery is vitally important. If appropriate therapeutic and preventive measures should not be instituted, tracheal intubation of the patient should be associated with a number of complications. We experienced a case of acute attack of asthma and pulmonary collapse during endotracheal intubation. A 54-year-old male who was scheduled for an emergency of primary corneo-scleral suture have had history of bronchial asthma. On the preoperative physical examination, there was no specific finding except expiratory wheezing. After endotracheal intubation with the aid of ketamine 2 mg/kg, pancuronium bromide 0.1 mg/kg and lidocaine 2 mg/kg, iv, acute asthmatic attack was appeared. Breathing sounds on the both lung fields can not be audible during manual ventilation and SpO(2) was dropped to 70% at F(1)O(2) 1.0. To relieve asthmatic attack, epinephrine(1: 1.000) 0.5 ml, sc, aminophylline 4 mg/kg, iv and methyprednisolone 1 mg/kg, iv were injected. Erosion of tracheal mucosa, blood clots and mucous plugs were found by the fibroptic bronchoscopy. After removal of blood clots and mucus, lung compliance and SpO2 were improved. The patient was discharged 7 days later without any complications or sequelae.

Keyword

Attack of asthma; Pulmonary collapse

MeSH Terms

Aged
Aminophylline
Asthma*
Bronchoscopy
Emergencies
Humans
Intubation*
Intubation, Intratracheal
Ketamine
Lidocaine
Lung
Lung Compliance
Male
Middle Aged
Mucous Membrane
Mucus
Pancuronium
Physical Examination
Pulmonary Disease, Chronic Obstructive
Respiratory Sounds
Sutures
Ventilation
Aminophylline
Ketamine
Lidocaine
Pancuronium