A new device that allows synchronous intermittent inspiratory chest tube occlusion with any mechanical ventilator.

Abstract

Controlling a massively leaking bronchopleural fistula (BPF) can prove difficult. In combination with acute respiratory failure (ARF), BPF results in a mortality of 81 percent. Intermittent inspiratory chest tube occlusion (IICTO) is recognized as effective in controlling even the largest BPF; however, IICTO, as previously described, is difficult to use for a variety of reasons. We report two cases of BPF in association with ARF managed with a simple new device that allows the application of IICTO with virtually any mechanical ventilator. The effectiveness of the device and associated technique in controlling BPF leaks is clearly demonstrated and may have played a role in the eventual recovery of a patient with BPF. Further study of the technique is warranted.