Providing one-lung ventilation in posttracheostomic tracheal stenosis for thoracoscopic plastic of the right diaphragm dome
https://doi.org/10.21292/2078-5658-2021-18-5-76-81
Abstract
The article is devoted to the consideration of a clinical case of providing artifcial one-lung ventilation for performing thoracoscopic plastic of the right dome of the diaphragm in a patient with grade 3 posttracheostomy cicatricial tracheal stenosis. The patient is presented after a new coronavirus infection COVID-19 from 2020, prolonged mechanical ventilation through a tracheostomy tube (74 days), the development of medium thoracic cicatricial tracheal stenosis of grade 3 (the lumen of the narrowest part of the trachea is 4 mm) after decannulation and the development of relaxation of the right dome of the diaphragm (according to CT data, the dome is located at the level of the IV intercostal space). The frst stage under conditions of combined general anesthesia and high-frequency ventilation of the lungs was performed to restore the lumen of the trachea by bougienage of the stenosis area with tubes of a rigid endoscope under the control of a fberoptic bronchoscope with further nasotracheal intubation with a thermoplastic single-lumen endotracheal tube with a diameter of 8.0 with a cuff. At the second stage, during thoracoscopic plastic of the right dome of the diaphragm, to provide artifcial one-lung ventilation, a bronchial blocker was used, introduced through the same endotracheal tube into the right main bronchus under the control of a fberoptic bronchoscope.
About the Authors
D. G. Kabakov
Petrovsky Russian Scientifc Center of Surgery
Russian Federation
Russian Federation
Dmitry G. Kabakov Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Department no. I
2, Abrikosovsky Lane, Moscow, 119991
A. Yu. Zaytsev
Petrovsky Russian Scientifc Center of Surgery; Sechenov University
Russian Federation
Russian Federation
Andrey Yu. Zaytsev Doctor of Medical Sciences, Head of Anesthesiology and Intensive Care Unit no. I
2, Abrikosovsky Lane, Moscow, 119991
M. A. Vyzhigina
Petrovsky Russian Scientifc Center of Surgery; Sechenov University
Russian Federation
Russian Federation
Margarita A. Vyzhigina Doctor of Medical Sciences, Professor, Chief Researcher of Anesthesiology and Intensive Care Department no. I
2, Abrikosovsky Lane, Moscow, 119991
K. V. Dubrovin
Petrovsky Russian Scientifc Center of Surgery; Sechenov University
Russian Federation
Russian Federation
Kirill V. Dubrovin Senior Researcher of Anesthesiology and Intensive Care Department no. I
2, Abrikosovsky Lane, Moscow, 119991
G. A. Kazaryan
Petrovsky Russian Scientifc Center of Surgery
Russian Federation
Russian Federation
Grigoriy A. Kazaryan Junior Researcher, Surgeon of Thoracic Surgery and Oncology Department
2, Abrikosovsky Lane, Moscow, 119991
D. I. Novikov
Petrovsky Russian Scientifc Center of Surgery
Russian Federation
Russian Federation
Denis I. Novikov Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Department no. I
2, Abrikosovsky Lane, Moscow, 119991
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Review
For citations:
Kabakov D.G., Zaytsev A.Yu., Vyzhigina M.A., Dubrovin K.V., Kazaryan G.A., Novikov D.I. Providing one-lung ventilation in posttracheostomic tracheal stenosis for thoracoscopic plastic of the right diaphragm dome. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2021;18(5):76-81. (In Russ.) https://doi.org/10.21292/2078-5658-2021-18-5-76-81
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