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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versión impresa ISSN 2448-8909
Resumen
FLORES-FRANCO, René Agustín; FRANCO-ESTRADA, Alexandro y VELAZQUEZ-JAUREGUI, Adrián. Treatment of acute lobar atelectasis by selective trans-bronchoscopic insufflation in critically ill intubated patients: a general hospital experience. Med. crít. (Col. Mex. Med. Crít.) [online]. 2021, vol.35, n.1, pp.28-33. Epub 28-Feb-2022. ISSN 2448-8909.
Introduction:
Acute lobar atelectasis (ALA) is a frequent complication in patients under mechanical ventilatory support that is usually resolved with the help of suctioning of tracheobronchial secretions and with respiratory physiotherapy. However, there are refractory cases in which bronchoscopy would be useful. Trans-bronchoscopic insufflation of the atelectatic lobe has been described but its technique and indications have not yet subject to consensus. We expose our experience with a personalized technique of trans-bronchoscopic insufflation in intubated patients with ALA.
Material and methods:
Retrospective review of eight illustrative cases of ALA with more than five days of evolution and refractory to conservative treatment according to our local institutional protocols, treated by trans-bronchoscopic insufflation with an Ambu bag.
Results:
Of the eight cases, we observe four cases with immediate resolution of ALA, three with a late resolution (24 hours later) and one with a complicated result.
Conclusions:
With the proper training, trans-bronchoscopic insufflation may be a useful treatment option in patients with ALA under mechanical ventilatory support.
Palabras llave : Pulmonary atelectasis; mechanical ventilation; bronchoscopy; physiotherapy.