Left main bronchial lavage with normal saline under fluoroscopy improved pulmonary mechanics in a neonate after the Damus-Kaye-Stansel procedure.

摘要

Flexible bronchoscopy with or without lavage is particularly important in the diagnosis and treatment of specific respiratory problems in critically ill infants and children hospitalized in the intensive care unit. The widespread application of bronchoscopy has enabled the removal of tenacious mucous plugs as a simple bedside procedure after Fontan procedures. However, bronchoscopy is challenging for the intensivist when it may not always be feasible, particularly with a smaller-sized endotracheal tube (ETT), as used in neonates.1 We report the successful use of left main bronchial saline lavage in an 11-day-old infant who underwent a Damus-Kaye-Stansel (DKS) procedure and developed "white-out" of the left lung in the postoperative period. The clinical situation was complicated by the requirement of high FtO2 and positive end-expiratory pressure (PEEP) to counter hypoxia, and bronchoscopy was not possible because of size discrepancies.