A 40-year-old woman presents to ICU with massive haemoptysis (estimated 600 mL in 24 hours) from a right upper lobe cavitating lesion. She is intubat...

Question

A 40-year-old woman presents to ICU with massive haemoptysis (estimated >600 mL in 24 hours) from a right upper lobe cavitating lesion. She is intubated for airway protection. Despite suctioning, blood is entering the left lung. What is the most effective immediate airway intervention to protect the left lung?

Accepted Answer

Insert a left-sided double-lumen endobronchial tube or left main bronchus bronchial blocker to isolate and protect the left lung

Answer

Place the patient in the left lateral position

Answer

Advance the endotracheal tube into the right main bronchus under fibreoptic guidance to isolate the bleeding side

Answer

Insert a Sengstaken-Blakemore tube

Answer

Increase PEEP to 20 cmH2O to tamponade the bleeding

uk-fficm MCQ (SBA): Massive Haemoptysis