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Suction was applied to prevent asphyxiation about 300 mL blood was removed. Intubation was performed immediately but bleeding through the endotracheal tube (ETT) continued to be significant. An initial chest X-ray revealed atelectasis in the left lung field ( Fig. Her white blood cell count was 3,460/mL, the hemoglobin level was 7.3 mg/dL, and the platelet count was 13,000/mm 3. Initial arterial blood gas analysis revealed a pH of 7.277, a pCO 2 of 49.9 mmHg, a pO 2 of 47.8 mmHg, and an SpO 2 of 76.6%. On admission, her initial vital signs were: blood pressure 150/100 mmHg, heart rate 152 beats/min, respiratory rate 34 beats/min, body temperature 36.6✬, and an oxygen saturation level of 60% in room air. She subsequently suffered severe graft failure and refractory pancytopenia. She had been diagnosed with aplastic anemia at 12 years of age and had received a bone marrow transplant 5 months prior. Case Report A 36 year old female was admitted with a 5-day history of hemoptysis and dyspnea.

#BAROTRAUMA DOWNLOADING MANUAL#

Here, we report a case of extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum following manual ventilation of a patient who had an airway obstruction caused by massive hemoptysis. Airway occlusion by blood clots is fatal in cases of massive hemoptysis and is a significant risk factor for increased airway pressure in mechanically ventilated patients. The risk of excessive airway pressure is even greater during manual ventilation of an intubated patient, because air leakage is not possible.

A high airway pressure is an important feature of the pathophysiology of barotrauma. Keywords: airway obstruction barotrauma hemoptysis ventilationīarotrauma is a potentially lethal complication of positive-pressure ventilation.

Nevertheless, the patient developed extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum. Manual ventilation was initiated to improve oxygenation, and emergency flexible bronchoscopy was performed to clear the airway. However, airway obstruction by blood clots triggered desaturation and ventilator malfunction. A 36-year-old female patient with aplastic anemia developed massive hemoptysis and was placed on ventilator support.

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