Tuberc Respir Dis.  2012 Feb;72(2):212-217.

Massive Hemoptysis Cases Intubated with the Univent(R) Bronchial Blocker for Lung Protection

• Moon JY
• Lee YS
• Lyu J
• Huh JW
• Hong SB
• Kim SW
• Lim CM
• Koh Y

Abstract

Massive hemoptysis is a life-threatening condition and sometimes leads to death due to airway obstruction rather than exsanguinations. In a critical hemoptysis, endotracheal intubation may be necessary to maintain adequate gas exchange and protect the unaffected side of the lung. Bronchial blockers (BBs), commonly used technique for one-lung ventilation in thoracic or cardiac surgeries, are valuable devices for protecting the airway in massive endobronchial bleeding. We report three cases intubated with BBs, Univent(R), in massive hemoptysis. We suggest that BBs are one of the indispensable equipments for respiratory specialized wards and intensive care units.

Keyword

Hemoptysis; Intubation; Airway management; instrumentation

MeSH Terms

Airway Management
Airway Obstruction
Hemoptysis
Hemorrhage
Intensive Care Units
Intubation
Intubation, Intratracheal
Lung
One-Lung Ventilation

Figure

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  Figure 1 Univent® torque control blocker (Fuji Systems Corporation, Tokyo, Japan).

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  Figure 2 A 67-year-old woman with aplastic anemia manifesting fever and pancytopenia. Physicians diagnosed fungal infection and NTM disease in the immunocompromised host (A~C). After hospitalization, massive hemoptysis from RML was confirmed by bronchoscope, she was intubated with Univent® torque control blocker (D, E, black arrow). Fifty days later, she was discharged (F). RML: right middle lobe; NTM: Non-tuberculous mycobacteria.

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  Figure 3 A 74-year-old man visited the emergency room and started to coughing up blood. Chest x-ray and chest computed tomography scan revealed reactivation of pulmonary tuberculosis and Rasmussen aneurysm (A~C). Hypoxemia deteriorated rapidly, and he was intubated with Univent® blocker (D, E, black arrow). He received treatment for bronchial artery embolization, and recovered from total atelectasis of the right lung three days later (F).

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  Figure 4 A 62-year-old man with NSCLC was hospitalized for pneumonia (A). Next day, he was treated with BAE due to recurrent hemoptysis. However, a life- threatening hemoptysis ocurred. After being intubated with Univent® blocker, it followed stopped bleeding. Chest computed tomography images showed necrotizing pneumonia in the left hemithorax (B). NSCLC: non-small cell lung cancer; BAE: bronchial artery embolization.

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