Flexible Bronchoscopy Combined With an Airway Maneuver for Foreign Material Removal Under Invasive Mechanical Ventilation

Georgios E Zakynthinos; Athanasios Mpaggeas; Konstantina Deskata; Christos Doudakmanis; Demosthenes Makris

doi:10.7759/cureus.44239

Flexible Bronchoscopy Combined With an Airway Maneuver for Foreign Material Removal Under Invasive Mechanical Ventilation

Cureus. 2023 Aug 28;15(8):e44239. doi: 10.7759/cureus.44239. eCollection 2023 Aug.

Authors

Georgios E Zakynthinos¹, Athanasios Mpaggeas², Konstantina Deskata³, Christos Doudakmanis⁴, Demosthenes Makris⁵

Affiliations

¹ Third Department of Cardiology, Athens Chest Disease Hospital "Sotiria", Athens, GRC.
² Department of Neurology, University Hospital of Larissa, Larissa, GRC.
³ Department of Critical Care, University General Hospital of Larissa, Larissa, GRC.
⁴ Department of Surgery, University Hospital of Larissa, Larissa, GRC.
⁵ Department of Critical Care, General University Hospital of Larissa, Larissa, GRC.

Abstract

We present a case of a patient who had aspirated a massive amount of food, leading to cardiac arrest, and had to be intubated because of severe hypoxemia. The hypoxemia persisted, regardless of the recruitment maneuvers, performance of flexible bronchoscopy, and suctioning through the ventilating tube, because we were unable to reach the left main bronchus (LMB), where the greatest amount was concentrated. However, we managed to overcome this problem by using a prototype handling technique to catheterize the LMB directly with the usage of the flexible bronchoscope. We introduce this handling technique for the removal of foreign material from the LMB, which will probably be really useful in emergency situations, because of its simplicity and effectiveness.

Keywords: airway obstruction; aspiration; emergency care; flexible bronchoscopy; invasive mechanical ventilation.

Publication types

Case Reports