Treatment for Collapsed Lung in Critically III Patients

Collapsed lung is a common problem in critically ill patients. Although respiratory therapy is a pri­mary and effective method of treatment, it is not suitable for some patients, such as those with rib fractures, hemothorax, or pneumothorax. Other pa­tients are too critical to wait for the results of repetitive respiratory care or cannot tolerate vigorous therapy. In 1973, a bedside procedure was introduced to re- expand the collapsed lung using a fiberoptic broncho­scope.¹ This procedure includes repetitive sputum suctioning and bronchial washing with normal saline solution. Although most of the lung collapse was re- expanded with the above procedure, some were re­fractory. This may be due to a lower lung compliance and higher critical opening pressure in the collapsed lung. If the collapse is left untreated it may become chronic and a secondary infection may occur.

Many devices were invented to overcome the lower lung compliance and higher critical opening pressure. In­trabronchial positive pressure ventilation using an endotracheal tube or a bronchoscope with a balloon cuff was introduced. All attained good results. Un­fortunately, these devices are complex and not readily available. We designed a simpler method to accomplish the same results, obtaining the same or even greater effect without any complications.
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