RT Journal Article
SR Electronic
T1 Stepwise multidisciplinary approach in very low birthweight infant with bronchopleural fistula
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e241721
DO 10.1136/bcr-2021-241721
VO 14
IS 7
A1 Anna Milan
A1 Iain Yardley
A1 Grenville Fox
A1 Virginie Meau-Petit
YR 2021
UL http://casereports.bmj.com/content/14/7/e241721.abstract
AB A 25-week gestation infant experienced chest infection complicated by septic shock and tension pneumothorax. Despite multiple drains, it was impossible to reinflate the lung, thus suggesting a bronchopleural fistula. Multidisciplinary meetings were arranged, involving the parents, and a stepwise approach was agreed. Chest drain repositioning, single lung ventilation and pleurodesis proved unsuccessful. In a rare window of relative stability, open chest surgery was performed at the cot-side by the paediatric general and cardiothoracic surgical teams. A large tear was identified at the carina, extending along the left main bronchus. This was repaired, with immediate clinical improvement. He was extubated 7 days later and discharged home on day 94 (CGA 39+0). This case report describes a successful stepwise multidisciplinary approach to a bronchopleural fistula in a very low birthweight infant, highlighting the potential for surgical intervention at cot-side and the value of involving the surgical team early on.