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Cardiothoracic and Vascular Anesthesia
Anesthesia and Pain Medicine 2009;4(1):32-35.
Published online January 30, 2009.
Difficult mechanical ventilation and hemodynamic caused by a main bronchial tumor : A case report
Hoon Jung, Sung Sik Park
Department of Anesthesiology and Pain Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
Unidirectional obstruction of a bronchus from any cause results in hyperinflation or atelectasis of the distal area. We experienced a patient that showed expiratory airway obstruction and this was caused by check-valve mechanism of bronchial tumor during anesthetic induction for spine surgery. A 60-year-old-man, who had left hilar lung cancer, entered the operating room to undergo spine surgery for metastatic tumor. Immediately after intubation, the patient's breathing sounds were not heard at the left lung field, and the patient displayed severe hemodynamic instability. The chest X-ray showed hyperinflation of the left lung with mediastinal shifting to the right side. With spontaneous recovery of the patient's self-ventilation, the vital signs returned to normal. Three days later, the operation was performed successfully under spinal anesthesia.
Key Words: airway obstruction, check-valve mechanism, lung cancer

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