Barotrama

One major concern after surgery is postoperative pulmonary complications such as atelectasis, aspiration, pneumonia, and respiratory failure. Progress in preoperative and postoperative rehabilitation, in systemic management including respiratory management, and progress in understanding the pathophysiology of acute respiratory failure have improved prevention and the outcome of treatment. However, some conditions remain very difficult to treat, like respiratory failure accompanied by infection or multiple organ failure...

We describe three cases of tension pneumothorax occurring during apnea testing for the determination of brain death. Every case needed needle thoracostomy for emergency chest deflation and/or a chest tube to be inserted rapidly. Moreover, haemodynamic and oxygenation parameters were impaired in each of the patients after these pneumothorax. This was uneventful for the two first patients (organs harvesting was contra-indicated or not consented by the patient's family), but might be responsible for damaging lungs in the third patient and consequently loosing the pulmonary graft...