Rigid bronchoscopic bridge to lung isolation in an airway emergency in congenital lobar emphysema.
Nishant Patel, Ummul Fabeena Mangaladan, Sushmita Bairagi et al.
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Case in brief
An infant with congenital lobar emphysema experienced rapid desaturation during induction for thoracoscopic lobectomy. Due to the lack of a suitable bronchial blocker and insufficient time for fibreoptic guidance, lung isolation was successfully achieved using a rigid bronchoscope for immediate left lung ventilation, followed by bougie-assisted endobronchial intubation. This approach restored oxygenation and allowed for the safe completion of the surgery.
What made this case unusual
The use of a rigid bronchoscope for lung isolation in an airway emergency is a notable technique that is not commonly reported in the context of congenital lobar emphysema.
Diagnostic / clinical pearl
Clinicians should consider rigid bronchoscope-guided intubation as a viable option for lung isolation in airway emergencies, particularly in cases of congenital lobar emphysema.
Why it matters
This case underscores the importance of having alternative airway management strategies available in critical situations, especially when conventional methods are not feasible.