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Canadian Journal of Anesthesia, Vol 41, 857-860, Copyright © 1994 by Canadian Anesthesiologists' Society

ARTICLES

Acute life-threatening intraoperative atelectasis

EG Pivalizza and AS Tonnesen
Department of Anesthesiology, University of Texas Medical School at Houston 77030.

A case is presented of acute intraoperative atelectasis causing profound hypoxaemia in a patient undergoing a combined epidural-general anaesthetic for hip surgery in the lateral position. The pathophysiology of the resultant ventilation-perfusion mismatch and the effects of applied positive end-expiratory pressure in the lateral position are explored. The emergency management is assessed, with emphasis on the role of bronchoscopy in diagnosis and treatment of this rare cause of life-threatening hypoxaemia in the operating room. This patient with risk factors for respiratory complications may have benefited from preoperative bronchoscopy to assist in lung expansion.




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Copyright © 1994 by the Canadian Anesthesiologists' Society.