Bronchopleural Fistula

[Sonny Crocket]

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Didn't do a lot of BPF's during residency. What's your DLT intubation technique here. Spontaneously breathing? Paralyze and get the tube in, isolate and then ventilate the good lung? Do whatever you want if they already have a chest drain?
Thanks in advance.

 

[Wiscoblue]

Size of fistula, size of patient, condition of contra lateral lung, eteology of BPF, airway assessment, presence of chest tube these would be some of the considerations. Also, it's good to know if pulm had done a bronch and the exact location of the fistula is known.

Having said that, if the leak is minor and the lungs are good if the airway is easy I'd go with propofol sux and DLT.

 

[Noyac]

What Wiscoblue said. Ditto in other words.