Removal of obstructing blood clot from the lower airway: an alternative suction technique

Bodenham, Andrew

doi:10.1046/j.1365-2044.2002.02273.x

Cited by 15 publications

(15 citation statements)

References 9 publications

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“…Furthermore this technique requires the expertise of specialists. Recently, alternative methods for removing endobronchial blood clots have been introduced, such as a Fogarty arterial embolectomy catheter or application of thrombolytics via a flexible bronchoscopy8,9. These methods are only recommended when severe respiratory compromise is present and other alternatives have failed.…”

Section: Discussionmentioning

confidence: 99%

Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

et al. 2014

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Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in life-threatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

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Section: Discussionmentioning

confidence: 99%

Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

et al. 2014

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“…These catheters often prove ineffective in removing large clots as the clots do not pass through the catheter and the catheter system cannot develop enough negative pressure [5]. Bodenham described an alternative technique in which negative pressure is directly applied to the tracheal tube using a Y-connector [6]. To prevent progressive air trapping we decided to reverse muscle relaxation and allow spontaneous breathing to resume.…”

Section: Discussionmentioning

confidence: 99%

“…Other rescue techniques that have been described when dealing with blood clots in the lower airway include the use of fiberoptic and rigid bronchoscopy in combination with lavage, suction devices, forceps, snares or arterial embolectomy catheters [6,8,9]. The use of the topical thrombolytic agents streptokinase and urokinase have also been successful [9,10] but they take some time to be effective.…”

Section: Discussionmentioning

confidence: 99%

Sugammadex rescue in a ‘can intubate but can't ventilate’ scenario

et al. 2014

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We present a case of a 7 year old female who was admitted to hospital with a post tonsillectomy haemorrhage 6 days after an elective day case tonsillectomy for recurrent tonsillitis. Following tracheal intubation the patients lungs' were almost impossible to ventilate due to blood clots within the trachea that could not be removed with suctioning. Reversal of the effects of rocuronium with sugammadex combined with lightening of anaesthesia resulted in a return of spontaneous ventilation and the cough relex, which proved to be life saving for this patient. Two large blood clots were expelled through the tracheal tube, clearing the airway. Flexible bronchoscopy revealed no further distal blood clots or tracheal obstruction. Bleeding from the inferior tonsillar artery was identified and treated. The patient made a full recovery and was discharged home 3 days later.

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“…Previous reports have demonstrated that an endotracheal tube (ETT) could function as a suction device to clear the airway. 1,2 However, additional equipment is needed to connect the ETT to a suction source, and it may not be immediately available in the operating room. We herein describe a modified suction technique that allows expeditious clearance of regurgitated vomitus during tracheal intubation.…”

Section: To the Editormentioning

confidence: 99%

A modified device for removing large regurgitation volume during tracheal intubation

Hung

Hsieh

2016

Can J Anesth/J Can Anesth

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Removal of obstructing blood clot from the lower airway: an alternative suction technique

Abstract: SummaryClotted blood or organised thrombus in the lower airway may present clinicians with life-threatening airway obstruction or pulmonary collapse. An alternative suction technique is described, which applies suction directly to a tracheal tube.

Cited by 15 publications

References 9 publications

Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

Sugammadex rescue in a ‘can intubate but can't ventilate’ scenario

A modified device for removing large regurgitation volume during tracheal intubation

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