Right pneumonectomy syndrome presenting as a cardiac arrest in a two-year-old

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Reshma AminPeter Cox

Abstract

Pneumonectomy syndrome is a rare complication after pneumonectomy with variable onset and presentation. It is characterized by extrinsic airway compression secondary to mediastinal shift. As far as we are aware, we are reporting the first pediatric case of pneumonectomy syndrome presenting as a cardio-pulmonary arrest. A two-year-old boy presented with a cardiac arrest 8 months after his pneumonectomy. He failed extubation twice. A flexible bronchoscopy was then performed which revealed external compression of the left mainstem bronchus. He underwent surgical correction with a prosthetic, thoracic implant. The patient's trachea was subsequently extubated to room air on postoperative day 1. He remains clinically stable at 6 month follow-up. Postpneumonectomy syndrome is a rare but serious complication after pneumonectomy. If the airway compression occurs in conjunction with compromised vena caval return, cardio-pulmonary arrest can occur. Therefore, timely diagnosis and early intervention is required.

References

Mar 1, 1978·The Annals of Thoracic Surgery·R SzarnickiJ Stark
Feb 1, 1990·Chest·J F Dumon
Mar 1, 1997·The Journal of Emergency Medicine·E D BartonP Rosen
Jun 30, 2004·The Journal of Thoracic and Cardiovascular Surgery·David J SugarbakerLambros S Zellos

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Citations

Jul 14, 2010·Pediatric Emergency Care·Paulo Sérgio Lucas da SilvaHenrique Monteiro Neto

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