Iatrogenic lung collapse in a neonate after recurrent endotracheal intubations and tracheal suctioning

Mohammad Alsalem, Ahmad I Alomari, Eid Kakish, Samah Awad

Journal of Clinical Neonatology 2017 6(3):187-189

Iatrogenic lung collapse due to complete main stem bronchus obstruction caused by recurrent intubations and repetitive tracheal toileting has been rarely reported in literature. The early diagnosis and proper management are imperative to avoid mortality. A 1-month-old male child, weighing 3 kg, developed a complete right main bronchus obstruction caused by granulation tissue, after multiple intubations and prolonged pediatric Intensive Care Unit ICU care, leading to a complete right lung collapse. Removal of the granulation tissue was complete and successful using rigid bronchoscopy and forceps. Careful atraumatic intubation should be attempted in all patients with extra care in the neonatal age group. An experienced doctor or experienced attentive pediatric ICU nurses should handle the bronchial suctioning of neonates to avoid trauma to the tracheal structures. A bronchial obstruction that may result in lung collapse should be suspected after traumatic or prolonged intubation with frequent airway suctioning, where the early diagnosis and proper management are imperative to avoid mortality.

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