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CARDIOVASCULAR ANESTHESIOLOGY

Intraoperative Contralateral Tension Pneumothorax During Pneumonectomy

Gordon N. Finlayson, MD^*, Albert B. Chiang, MD^*, Jay B. Brodsky, MD^*, and Walter B. Cannon, MD

From the Departments of *Anesthesia and Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.

Address correspondence and reprint requests to Dr. Jay Brodsky, Department of Anesthesia, H-3580, Stanford University Medical Center, Stanford, CA 94305. Address e-mail to Jbrodsky{at}stanford.edu.

Abstract

Unrecognized tension pneumothorax can have catastrophic consequences. We report a case of a patient who developed a contralateral tension pneumothorax during thoracotomy without the classic signs of marked hypoxemia and hemodynamic instability. A tension pneumothorax should be considered in any patient who develops high peak inspiratory pressures during one-lung ventilation with an open chest, even in the absence of the classic signs of hypoxemia and hypotension.

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