Newly Published
Images in Anesthesiology  |   March 2019
Severe Bronchopleural Fistula Patched with a Bronchial Blocker
Author Notes
  • From the Department of Anesthesiology, Perioperative Medicine, and Pain Management (C.S.B., H.R.-R., J.L.) and the Dewitt Daughtry Family Department of Surgery, Division of Trauma (V.J.H.), University of Miami Miller School of Medicine, Miami, Florida; Jackson Memorial Hospital, Miami, Florida (C.S.B., H.R.-R.); and Ryder Trauma Center, Miami, Florida (V.J.H., J.L.).
  • Correspondence: Address correspondence to Dr. Louro: JLouro1@med.miami.edu
Article Information
Images in Anesthesiology / Respiratory System / Technology / Equipment / Monitoring
Images in Anesthesiology   |   March 2019
Severe Bronchopleural Fistula Patched with a Bronchial Blocker
Anesthesiology Newly Published on March 13, 2019. doi:10.1097/ALN.0000000000002686
Anesthesiology Newly Published on March 13, 2019. doi:10.1097/ALN.0000000000002686
We present two chest x-rays that were taken 8 h apart. The first one (A) depicts a right (R)-sided pneumothorax with two large bore (32-French) chest tubes and a smaller (22-French) chest tube. The pneumothorax was unable to be drained with the three chest tubes due to a bronchopleural fistula because tidal volumes escaped through the fistula. The second image (B), taken after placement of a bronchial blocker at the level of the right lower segmental bronchus, depicts a consolidation of the right lower lobe and the resolution of the bronchopleural fistula with reexpansion of the lungs. The bronchial blocker was placed under direct bronchoscopic guidance with the cuff well beyond the takeoff of the right upper lobe bronchus. This patient was intubated, sedated, and chemically paralyzed due to severe respiratory failure.