Can a chest tube cause a bronchopleural fistula?

A bronchopleural fistula are often discovered when a chest tube is unable to be removed following lung surgery due to a persistent air leak. There may be continuous bubbling, or instead, an air leak may be present only during inspiration or expiration.

How do you ventilate a patient with bronchopleural fistula?

The goal of mechanical ventilation is to minimize flow across the fistula by keeping airway pressure below the critical opening pressure of the fistula.

  1. Minimize PEEP.
  2. Short inspiratory time.
  3. Low tidal volumes.
  4. Ideally spontaneous breathing (likely not feasible in this case)
  5. Permissive hypercapnia.

What is differential lung ventilation?

Differential lung ventilation (DLV) is used to salvage ventilatory support in severe unilateral lung disease in the critical care setting. However, DLV with a double-lumen tube is associated with serious complications such as tube displacement during ventilatory management.

What is alveolar pleural fistula?

An alveolopleural fistula (APF) is a pathologic communication between the pulmonary parenchyma distal to a segmental bronchus (alveoli) and the pleural space. It presents as a pneumothorax and if it persists beyond five days is labeled as a prolonged air leak (PAL).

How is pneumatocele treated?

Medical care for pneumatocele is treatment of the underlying condition. In most circumstances, this involves administration of broad-spectrum antibiotics to treat the pneumonia. Therapy should be directed against the most common bacterial organisms in children, including S aureus and S pneumoniae.

Does a pneumatocele go away?

These lesions are asymptomatic and transient in most patients and disappear by about 6 weeks. They usually do not require any specific treatment or intervention. Surgical intervention is only necessary when pneumatoceles cause cardiopulmonary compromise or rupture into the pleural space.

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