좌전폐적출술중 발생한 심한 무기폐

Abstract

Pulmonary atelectasis is a common complication following surgery under general anesthesia. It is well documented for the anesthetic procedure to incur diffuse microatelectasis. However profound pulmonary collapse are rare. Total or segmental lung collapses are usually resulted from the obstruction of bronchial pathway by secretions such as mucus, blood and pus etc. We had a case of profound atelectasis developed during the left pneumonectomy of bronchiectasis. Secretions with copious pus was noticed which the lungs were surgically manipulated and vigorous suction through the endotracheal tube was carried out. However a spillage of pus into the dependent lung could not be prevented. We assumed that the cause of the atelectasis was an obstruction of the left bronhus by pus drained from the surgical lesions. With a conventional single-lumen endotracheal tube it is very difficult to separate two lungs and prevent a spillage of pus into a healthy dependent lung. Therefore we recommend the use a double-lumen tube to prevent such a complication and also facilitate better surgical field.