Friday, November 6, 2009

Into the Fire

Please see the last two posts for the first two parts of the case. The patient has respiratory distress and needs to be intubated. Here is your routine CXR after intubation.

(Obviously this is a different patient, but the pathology should be obvious.)

Challenge: Despite FiO2 of 100%, the patient's oxygen saturation hovers just below 90%. Why?

Image shown under fair use.

3 comments:

Suheil said...

The ET tube went too far in and is only ventilating the right lung? that is.. it entered the right main bronchus instead of being above the level of the carina?

Suheil said...

The ET tube has entered the right main bronchus and is only ventilating the right lung?

Craig Chen said...

good eye!
-
Into the Fire

This is a right mainstem bronchus intubation; the tip of the endotracheal tube projects below the carina into the right bronchus intermedius.

Source: LearningRadiology.com