Anesth Pain Med.  2020 Jan;15(1):78-82. 10.17085/apm.2020.15.1.78.

Cardiac arrest caused by contralateral tension pneumothorax during one-lung ventilation - A case report –

• Lee SK
• Seo KH
• Kim YJ
• Youn EJ
• Lee JS
• Park J
• Moon HS

• KMID: 2500459
• DOI: http://doi.org/10.17085/apm.2020.15.1.78

Abstract

Background
Tension pneumothorax on the contralateral lung during one-lung ventilation (OLV) can be life-threatening if not rapidly diagnosed and managed. However, diagnosis is often delayed because the classic signs of tension pneumothorax are similar to clinical manifestations commonly observed during OLV. Case: We report a case of contralateral tension pneumothorax in a patient undergoing right upper lobectomy during OLV. The patient suffered from sudden cardiac arrest and was assisted by extra-corporeal membrane oxygenation.
Conclusions
Contralateral pneumothorax during OLV is rare but can occur at any time. Therefore, anesthesiologists should consider this critical complication.

Keyword

Heart arrest; One-lung ventilation; Pneumothorax; Thoracic surgery

Figure

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  Fig. 1 Chest computed tomography shows emphysema with bullae in the bilateral lung. Arrow indicates the large bulla on the left lung.

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  Fig. 2 Chest anteroposterior shows marked pneumothorax in the left lung.

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  Fig. 3 Chest anteroposterior immediately after insertion of the chest tube shows re-expansion of the left lung.

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