Abstract
A Dumon-type bronchial stent was placed in a lung cancer patient presenting left lung collapse due to stenosis of the left main bronchus. High frequency jet ventilation was then applied to the left lung through a channel of a bronchofiberscope introduced in the left main bronchus proximal to the stent. Immediately after re-expansion of the left lung, circulatory collapse including severe hypotension, bradycardia and hypoxia developed. Considering that abrupt ST elevation and complete A-V block on ECG monitor and cerebral infarction on later CT examination were also accompanied with the event, multiple emboli was suspected as one of the causes of circulatory collapse in addition to re-expansion pulmonary edema. It was presumable that thrombi or tumor breakdowns existed in the left pulmonary vessel might have entered in the systemic circulation following re-expansion and might have been transported to the heart and brain. We should be aware of developing not only re-expansion pulmonary edema but also multiembolism after rapid re-expansion of the lung by jet ventilation in a patient with long term collapse of the lung.
