What are the possible complications of bronchial intubation in pulmonary interstitial emphysema (PIE)?

Updated: Jun 25, 2019
  • Author: Abhay J Bhatt, MD, MBBS; Chief Editor: Muhammad Aslam, MD  more...
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Answer

Potential complications of selective intubation/ventilation include the following:

  • Atelectasis in the affected lung
  • Injury to the bronchial mucosa, with subsequent scarring and stenosis
  • Acute hypoventilation or hypoxemia if ventilating one lung is inadequate
  • Excessive secretions
  • Hyperinflation of the intubated (nonoccluded) lung
  • Upper lobe collapse when intubating the right lung
  • Bradycardia

Despite the potential risks, selective bronchial intubation is a desirable alternative to lobectomy in a patient with persistent, severe localized PIE that is causing a mediastinal shift and compression atelectasis that is refractory to conservative management. This procedure should be attempted before any surgical intervention.


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