Publique en esta revista
Información de la revista
Vol. 54. Núm. 2.
Páginas 99 (Febrero 2018)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 54. Núm. 2.
Páginas 99 (Febrero 2018)
Clinical Image
DOI: 10.1016/j.arbres.2017.05.019
Acceso a texto completo
Tracheobronchomegaly in Intubated Ventilation of ARDS
Traqueobroncomegalia en intubación y ventilación mecánica en un caso de síndrome de dificultad respiratoria aguda (SDRA)
Visitas
1515
Yanxia Geng, Jiang Zhou
Autor para correspondencia
1967chch@163.com

Corresponding author.
, Zhimin Liu
Intensive Care Unit, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China
Información del artículo
Texto completo
Descargar PDF
Estadísticas
Figuras (1)
Texto completo

A 79-year-old man with a history of pulmonary fibrosis and Sjogren's syndrome was admitted to ICU for management of severe ARDS (Acute Respiratory Distress Syndrome) after radical prostatectomy. He presented with respiratory distress with bilateral opacities in chest radiograph (Fig. 1A). Tracheal intubation was performed the next day. However, the tidal volume continued to be instable at about 50–200ml even under fully sedation. A serious gas leakage was found as breath flow could be heard, which became better when head position fixed to the left. Taking back his history, he had had untreated tracheal abnormalities for decades. Chest computed tomography later showed diverticulum on both sides at the upper part of the trachea, and marked dilated trachea at the lower portion (Fig. 1B). Dueing to the poor attachment between the cuff of the endotracheal tube and the trachea wall, recruitment maneuvers for ARDS did not go well. The patient's condition continued to deteriorate and eventually died on the 11th day at ICU. Tracheobronchomegaly is a rare disease characterized by abnormally enlarged tracheo-bronchial tree. Chest X-ray may be misleading as it is easily overlooked on radiograph (Fig. 1A). Inexplicable poor ventilation in intubated patients should take into account the possibility of anatomic abnormalities, such as tracheobronchomegaly.

Fig. 1.

A) Chest X-ray at admission shows bilateral opacities and easily overlooked enlarged trachea (white arrow). B) Coronary computed tomography (CT) image showing diverticulums at proximal trachea. Diameters of distal trachea, right and left main bronchus were 36mm, 24mm, and 22mm respectively.

(0,14MB).
Copyright © 2017. SEPAR
Idiomas
Archivos de Bronconeumología

Suscríbase a la newsletter

Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.