Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

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ÀÌÈ«¿­(Lee Hong-Yeul) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
ÀÓÃʼ±(Leem Cho-Sun) - Seoul National University College of Medicine Bundang Hospital Department of Internal Medicine
ÀÌÀçÈ£(Lee Jae-Ho) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
ÀÌÃáÅÃ(Lee Choon-Taek) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine
Á¶¿µÀç(Cho Young-Jae) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Internal Medicine

Abstract

Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in life-threatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

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