Prophylactic Use of Continuous Positive Airway Pressure to Operative Lung During One-Lung Ventilation Can Minimize Bleomycin Pulmonary Toxicity: A Report of Two Cases

Nicholas Cavanaugh; Sudhakar Subramani; Tyler J Foster; Satoshi Hanada

doi:10.7759/cureus.36150

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Prophylactic Use of Continuous Positive Airway Pressure to Operative Lung During One-Lung Ventilation Can Minimize Bleomycin Pulmonary Toxicity: A Report of Two Cases

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Prophylactic Use of Continuous Positive Airway Pressure to Operative Lung During One-Lung Ventilation Can Minimize Bleomycin Pulmonary Toxicity: A Report of Two Cases

Nicholas Cavanaugh, Sudhakar Subramani, Tyler J Foster and Satoshi Hanada

Curēus (Palo Alto, CA), Vol.15(3), e36150

03/14/2023

DOI: 10.7759/cureus.36150

PMCID: PMC10101724

PMID: 37065344

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Abstract

Bleomycin, a common antineoplastic agent, is known to cause bleomycin pulmonary toxicity when the lungs are exposed to a high fraction of inspired oxygen (FiO2) level. Thus, intraoperative one-lung ventilation (OLV) is challenging in a patient with bleomycin treatment because maintaining high FiO2 during OLV is a common practice in thoracic surgery to ensure adequate oxygenation while providing adequate lung isolation. We report two thoracic surgical cases where prophylactic continuous positive airway pressure (CPAP) was applied on the non-dependent lung during OLV while limiting FiO2 to prevent postoperative respiratory complications.

Anesthesiology

Thoracic Surgery

Vascular Surgery

bleomycin

Cardiac

one-lung ventilation

pulmonary toxicity

Thoracic

thoracic anesthesia

video-assisted thoracoscopic surgery

Details

Title: Subtitle: Prophylactic Use of Continuous Positive Airway Pressure to Operative Lung During One-Lung Ventilation Can Minimize Bleomycin Pulmonary Toxicity: A Report of Two Cases
Creators: Nicholas Cavanaugh - Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, USA Department of Anesthesia, MercyOne Des Moines Medical Center, Des Moines, USA
Sudhakar Subramani - University of Iowa
Tyler J Foster - Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, USA Department of Anesthesia, MercyOne Des Moines Medical Center, Des Moines, USA
Satoshi Hanada - University of Iowa
Resource Type: Journal article
Publication Details: Curēus (Palo Alto, CA), Vol.15(3), e36150
DOI: 10.7759/cureus.36150
PMID: 37065344
PMCID: PMC10101724
NLM abbreviation: Cureus
eISSN: 2168-8184
Publisher: Cureus
Language: English
Date published: 03/14/2023
Academic Unit: Anesthesia
Record Identifier: 9984388759102771

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