Management of six episodes of intraoperative cardiac arrests in an infant with traumatic bronchial rupture: A case report

Abstract

Rationale: Traumatic bronchial rupture in infants usually necessitates surgical intervention, with few reports documenting instances of multiple cardiac arrests occurring during surgery under conditions of severe hypoxemia. Patient concerns: A 3-year-old boy after trauma presented with severe hypoxemia for 2 days and was urgently transferred to the operating room for surgery, 6 episodes of cardiac arrest happend during surgery. Diagnoses: The baby was diagnosed with bronchial rupture based on the history of trauma, clinica manifestations, and intraoperative findings. Interventions: Intrathoracic cardiac compression and intravenous adrenaline were administrated. Outcomes: The normal sinus rhythm of the heart was successfully restored within 1 minute on each occasion, facilitating the smooth completion of the surgical procedure. By the end of surgery, SpO2 levels had rebounded to 95% and remained stable. Lessons: Inadequate management of bronchial ruptures in infants frequently coincides with severe hypoxemia, necessitating immediate surgical intervention. Prompt identification and management of cardiac arrest by anesthetists during surgery is imperative to reduce mortality.