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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