Korean J Anesthesiol.  2007 Jul;53(1):127-131. 10.4097/kjae.2007.53.1.127.

Total Atelectasis after Intubation of a Double Lumen Tube: A case report

• Shin JW
• Kang HS
• Lee SK
• Kim YM
• Moon HS

• KMID: 2238311
• DOI: http://doi.org/10.4097/kjae.2007.53.1.127

Abstract

The intubation of a double lumen endotracheal tube (DLT) has become the technique of choice for most procedures requiring one lung ventilation (OLV). The potential complications of the use of DLT are airway ruptures and malpositions of the DLT which can induce an increase of airway pressure, hypercapnia, severe hypoxemia, and other effects during the induction of general anesthesia. The intractable hypoxia due to total lung atelectasis is one of the very rare complications during and after intubation of the DLT. We experienced a 16 year-old male patient with severe hypoxia scheduled for thoracoscopy after a position change from supine to lateral decubitus. The hypoxia was unable to be easily corrected by endobronchial suction, rechecking of DLT position with fiberoptic bronchoscope, and manual positive ventilation, even after a position change to supine. An emergent chest X-ray revealed total atelectasis of the right lung that was relieved gradually by general supportive care at the intensive care unit.

Keyword

atelectasis; double lumen endotracheal tube; hypoxia; malposition of DLT

MeSH Terms

Adolescent
Anesthesia, General
Anoxia
Bronchoscopes
Humans
Hypercapnia
Intensive Care Units
Intubation*
Lung
Male
One-Lung Ventilation
Pulmonary Atelectasis*
Rupture
Suction
Thoracoscopy
Thorax
Ventilation