Anaesthetic management of tracheobronchial rupture following blunt chest trauma.

Abstract

Injuries to the tracheobronchial tree are a well-recognized sequel of massive blunt trauma to the chest, and although unusual, are life threatening. We report a 16-year-old-boy who developed complete disruption of both bronchi after a motor vehicle accident. After induction of general anaesthesia and oral intubation, ventilation could not be maintained, and oxygenation worsened abruptly with peripheral oxygen saturation values less than 60%. Jet ventilation through two intrabronchial catheters, inserted via emergency thoracotomy, raised the saturation from 60% to 100%, and surgery thereafter was straightforward. The anaesthetic management of tracheobronchial repair is discussed.