Emergency Removal of Sludged Blood from Main Bronchus with Cryotherapy through Bronchoscope in Rescuing an Acute Respiratory Failure Caused by Massive Blood Clot Obstruction

Fu Enqing,Wang Yan

doi:10.23937/2378-3516/1410100

Abstract

Massive hemoptysis (over 200 ml at one go or over 500 ml in twenty-four hours) is considered as a serious case. If the blood cannot be expectorated out from bronchus, sludged blood will form and obstruct the bronchus in a matter of a few minutes. Then an acute respiratory failure would be the immediate result, which might lead to a critical state or death of the patient. The most effective method to rescue patient is to suction off the sludged blood with a bronchoscope. But bronchoscopy normally is unable to draw-off the sludged blood from the bronchus because of the strong adhesive power of the sludged blood. However, cryotherapy under bronchoscopy may make sludged blood temperature cool below zero and become solid and then take out the sludged blood from the bronchus in a short time and rescue patient.

Highlights

Massive hemoptysis is a critical emergent state for patients
Hemoptysis occurred during artificial dialysis and sludged blood obstructed the right main bronchus completely
If either the right or left main bronchus was obstructed by blood clot completely, the right main bronchus in particular, most patients would suffer from respiratory failure

Summary

Introduction

If the blood remains static in bronchus for several minutes, it would form sludged blood and obstruct the bronchus. Should this happen, most patients would suffer from acute respiratory failure, and sometimes the situation could be life-threatening. To eliminate the sludged blood from the bronchus quickly is a key step to save the situation. Many physicians thought that flexible or rigid bronchoscopy could help do the job [1,2], that cryotherapy under bronchoscopy can speed up the process of removing blood clot and bring the patient to safety. No one used the cryotherapy to rescue any patient with sludged blood obstructed main bronchus from former reports. This report displays a successful case rescue

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Discussion

Conclusion