Biomaterial Database

High-Frequency Jet Ventilation for a Patient With Tracheomediastinal Fistula, Tension Pneumomediastinum, and Pneumothorax: A Case Report. 2020

Chi Ho Chan, and Elizabeth S J Tan, and Kenny W T Loh, and Sharon G K Ong

From the Departments of Anesthesiology.

Tracheomediastinal fistula (TMF) is an uncommon condition and carries a high mortality. We report the anesthetic management of a patient with TMF using stent insertion via rigid bronchoscopy. The TMF was a complication of double-lumen endotracheal tube insertion resulting in a tension pneumomediastinum. Initial intraoperative attempts to ventilate the lungs and overcome the air leak with high gas flow of 45 L/min via the side port of the bronchoscope resulted in a pneumothorax. This case report demonstrates that high-frequency jet ventilation can minimize the air leak and avoid barotrauma during anesthesia for TMF repair.

UI	MeSH Term	Description	Entries
D008478	Mediastinal Emphysema	Presence of air in the mediastinal tissues due to leakage of air from the tracheobronchial tree, usually as a result of trauma.	Emphysema, Mediastinal,Interstitial Emphysema,Interstitial Emphysema of Lung,Pneumomediastinum,Pulmonary Interstitial Emphysema,Emphysema, Interstitial,Emphysema, Pulmonary Interstitial,Emphysemas, Pulmonary Interstitial,Interstitial Emphysema, Pulmonary,Interstitial Emphysemas, Pulmonary,Lung Interstitial Emphysema,Mediastinal Emphysemas,Pneumomediastinums,Pulmonary Interstitial Emphysemas
D011030	Pneumothorax	An accumulation of air or gas in the PLEURAL CAVITY, which may occur spontaneously or as a result of trauma or a pathological process. The gas may also be introduced deliberately during PNEUMOTHORAX, ARTIFICIAL.	Pneumothorax, Primary Spontaneous,Pressure Pneumothorax,Primary Spontaneous Pneumothorax,Spontaneous Pneumothorax,Tension Pneumothorax,Pneumothorax, Pressure,Pneumothorax, Spontaneous,Pneumothorax, Tension,Spontaneous Pneumothorax, Primary
D001999	Bronchoscopy	Endoscopic examination, therapy or surgery of the bronchi.	Bronchoscopic Surgical Procedures,Surgical Procedures, Bronchoscopic,Bronchoscopic Surgery,Surgery, Bronchoscopic,Bronchoscopic Surgeries,Bronchoscopic Surgical Procedure,Bronchoscopies,Surgeries, Bronchoscopic,Surgical Procedure, Bronchoscopic
D005402	Fistula	Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body.	Fistulas
D006611	High-Frequency Jet Ventilation	Respiratory support system used primarily with rates of about 100 to 200/min with volumes of from about one to three times predicted anatomic dead space. Used to treat respiratory failure and maintain ventilation under severe circumstances.	Ventilation, High Frequency Jet,High Frequency Jet Ventilation,High-Frequency Jet Ventilations,Jet Ventilation, High-Frequency,Jet Ventilations, High-Frequency,Ventilation, High-Frequency Jet,Ventilations, High-Frequency Jet
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man