Abstract
BackgroundCardiac herniation is a serious postoperative complication of extrapleural pneumonectomy (EPP) and is reportedly preventable by reducing the suction pressure of the chest drain.Case presentationWe describe a patient in whom respiratory failure, which was caused by impending tension pneumothorax after EPP, was successfully treated via normal suction pressure of the chest drain. A lower suction pressure (− 7 cmH2O) was chosen as an alternative to the setting typically used for postoperative drainage (− 15 cmH2O). As a result, the wound in the chest wall functioned as an antireflux check valve, leading to the development of impending tension pneumothorax.ConclusionsImpending tension pneumothorax presents with an abnormal elevation of intrapleural pressure on the affected side. This phenomenon can be effectively treated by increasing the suction pressure in the chest drain.
Highlights
Cardiac herniation is a serious postoperative complication of extrapleural pneumonectomy (EPP) and is reportedly preventable by reducing the suction pressure of the chest drain.Case presentation: We describe a patient in whom respiratory failure, which was caused by impending tension pneumothorax after EPP, was successfully treated via normal suction pressure of the chest drain
Impending tension pneumothorax presents with an abnormal elevation of intrapleural pressure on the affected side. This phenomenon can be effectively treated by increasing the suction pressure in the chest drain
The present report describes our experience with a patient who developed impending tension pneumothorax on the affected side after EPP, followed by hypercarbia associated with compression of the unaffected lung
Summary
The chest drain suction pressure after EPP is often set lower than the typical setting to prevent cardiac herniation as a postoperative complication. In such cases, tension pneumothorax may develop on the affected side. Tension pneumothorax may develop on the affected side This phenomenon can be effectively treated by increasing the suction pressure in the chest drain. A case of cardiac herniation after extrapleural pneumonectomy for malignant thymoma. Natural history of bronchopleural fistula after pneumonectomy: a review of 96 cases. Author details 1Department of Anesthesiology and Pain Clinic, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan. Author details 1Department of Anesthesiology and Pain Clinic, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan. 2Department of Anesthesiology and Pain Medicine, School of Medicine, Juntendo University, Tokyo, Japan
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
