Treatment for intratracheal bleeding due to blunt chest trauma

Abstract

Persistent intratracheal bleeding is one of the most dangerous conditions in patients with severe blunt thoracic trauma, because patients may be asphyxiated in their own blood. Since 1981 we have used Endotracheal Tube with Movable Blocker (UNIVENT) to separate the bleeding lung from non-bleeding lung in eight patients with continuous intratracheal bleeding. The progression of acute respiratory failure could be prevented in all patients by this treatment combined with well controled mechanical ventilation.
Four patients underwent the resection of bleeding lung a few hours after the separation of lung with UNIVENT. Two patients survived but other two patients died of the associated brain contusion on the sixth and eighth postoperative day.
Remaining four patients were observed closely and waited until intratracheal bleeding stopped spontaneously. It took 8, 20, 36 hours and six days respectively to fulfil the purpose. One patient needed thoracotomy thereafter to control the persistent intrathoracic bleeding. All four patients survived.