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Canadian Journal of Anesthesia, Vol 33, 662-665, Copyright © 1986 by Canadian Anesthesiologists' Society

Hydropneumothorax - An Unusual Complication of Lung Lavage

ELLIOT T. HUDES MD1, JOHN W. BRADLEY BSC MD FRCP1, and JOHN BREBNER MD PHD FRCP1

1 Department of Anaesthesia, Toronto General Hospital and University of Toronto, Toronto, Ontario

Address correspondence to: Dr. John Bradley, Department of Anaesthesia, Toronto General Hospital, Eaton Wing 2-306, 200 Elizabeth Street, Toronto, Ontario, M5G 1L7.

Hydropneumothorax is an uncommon but potentially fatal complication for a patient undergoing positive pressure ventilation. The case of a 23-year-old woman with severe asthma requiring lung lavage is described. Twenty minutes after an uneventful left lung lavage, the patient experienced increased peak airway pressure, decreased oxygen saturation and hypercarbia, despite ventilation with 90 per cent oxygen. A chest x-ray revealed mediastinal shift and a left sided pneumothorax. Drainage was carried out, revealing air and clear fluid in the pleural space. The importance of technical problems such as patient and endotracheal tube positioning, elimination of cross-spilling and cardiopulmonary effects of lavage are discussed.

Key Words: LUNG: lavage, alveolar proteinosis, asthma • COMPLICATIONS: hydropneumothorax






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Copyright © 1986 by the Canadian Anesthesiologists' Society.