False Passage During Single-Lung Ventilation in a Tracheostomized Patient: Intraoperative Recognition and Rescue.
David Revuelta Quintero, Guillem Urquijo, Maria Antonia Perelló Llaneras et al.
✦ AI-curated · Sources linked
Case in brief
A 63-year-old man with a recent tracheostomy due to cervical cellulitis underwent urgent thoracotomy for mediastinal debridement. During single-lung ventilation, he experienced abrupt loss of capnography and ventilation difficulties. Bronchoscopy revealed malposition of the tracheostomy tube leading to false passage ventilation, compounded by local infection. Emergency orotracheal intubation was successfully performed, restoring ventilation and allowing the procedure to continue.
What made this case unusual
The case illustrates the complications of false passage ventilation in a tracheostomized patient during single-lung ventilation, particularly in the context of recent stoma and severe local infection.
Diagnostic / clinical pearl
Clinicians should be vigilant for signs of airway loss in tracheostomized patients, especially during complex procedures involving single-lung ventilation.
Why it matters
This case emphasizes the need for rapid recognition and intervention strategies in managing airway complications in high-risk surgical settings.