A Case of Successful Management with Percutaneous Cardiopulmonary Support for Pulmonary Hypertension Associated with Pneumonectomy in Blunt Bronchial Injury

We report a patient with pulmonary hypertension complicated with pneumonectomy in blunt traumatic injury to the bronchus successfully managed by percutaneous cardiopulmonary support (POPS). A 4-year-old girl injured in a traffic accident was transferred to our hospital. She had thoracic injury with respiratory failure, and we diagnosed bilateral hemopneumothorax. Despite insertion of bilateral chest tubes and intubation, the left lung was not inflated, showing continued massive air leakage. Pneumonectomy of the left lung was performed for the left main bronchial injury. After the operation, PCPS was started because of pulmonary hypertension associated with deteriorated hemodynamics and oxygenation. Following this, the respiratory and hemodynamic states became stable. PCPS was continued for 5 days and the ventilator was needed for 11 days. The patient was discharged on day 52. We considered the pneumonectomy, contralateral lung contusion, drugs, hypoxic pulmonary vasoconstriction, and ventilator as causes of pulmonary hypertension. PCPS is one of the useful treatments for severe chest trauma.