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After the fire, the ignited airway with charred stent.
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Figure 2: After the fire, the ignited airway with charred stent.

Mentions: Granulation tissue and the upper part of the stent were visualized beyond the vocal cords using rigid bronchoscopy (Fig. 1). Granulation tissue was removed and coagulation initiated with electrocautery at which time a loud popping sound was heard and smoke was seen leaking from the mouth and bronchoscope. The stent was charred and the mucosa of the lower airway, including the main bronchi, was covered with gray dust (Fig. 2). The stent and grey dust in the airway were removed and the area irrigated with saline. Following tracheal intubation, the patient was transferred to the intensive care unit for mechanical ventilation. He was treated with N-acetylcysteine, ipratropium bromide, and salbutamol nebulizers, hydrocortisone, and antibiotics. The next day the patient was weaned from mechanical ventilation with an oxygen saturation of 95-99% according to pulse oximetry.

Airway fire injury during rigid bronchoscopy in a patient with a silicon stent -A case report-

Lee JY, Park CB, Cho EJ, Kim CJ, Chea JS, Lee BH, Kim JO, Chung MY - Korean J Anesthesiol (2012)

Bottom Line: Airway fires during rigid bronchoscopy are rare, but can have potentially devastating consequences.Pulmonologist and anesthesiologist undertaking this type of procedure should be aware of this serious problem and be familiar with measures to avoid this possibly fatal complication.We report the case of a 24-year-old patient with a silicone stent who experienced an electrocautery-induced airway fire during rigid bronchoscopy.

Affiliation: Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
Therapeutic bronchoscopy is widely employed as an effective first-line treatment for patients with central airway obstructions. Airway fires during rigid bronchoscopy are rare, but can have potentially devastating consequences. Pulmonologist and anesthesiologist undertaking this type of procedure should be aware of this serious problem and be familiar with measures to avoid this possibly fatal complication. We report the case of a 24-year-old patient with a silicone stent who experienced an electrocautery-induced airway fire during rigid bronchoscopy.

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