기관지흉막루 환자의 마취

Bronchopleural fistula is an uncommon but serious complication of lung resection, with a high mortality and morbidity. Problems associated with bronchopleural fistula and empyema are related to positive-pressure ventilation, which may result in infectious contamination of healthy lung tissue, loss of air, decreased alveolar ventilation leading to carbon dioxide retention, and the development of a tension pneumothorax. We experienced difficult intubation in patient who has large bronchopleural fistula and anatomic deviations of intact bronchus of the left lung, so we used a long single lumen tube made by attaching an another cuffed endotracheal tube under direct vision. The arterial oxygenation was effective, but carbon dioxide elimination was inadequate. After the operation, the ordinary cuffed endotracheal tube was intubated orally and the patient was transferred to the ward without problems 6 days after the operation. (Korean J Anesthesiol l996; 31: 649-653)