Bronchoscopic drainage with full personal protective equipment (PPE) saved a life of COVID-19 infected patient with ventilator associated pneumonic athelectasis from the Diamond Princess Cruise Ship

Abstract

A 75 year-old American passenger was transferred to our hospital, infected in Diamond Princess, with pneumonia due to COVID-19 infection. At the beginning, he walked in but on day 4, he needed intubation and mechanical ventilation support because of worsening respiratory function due to wide-spread pneumonia. Despite the ventilation, his respiratory condition did not improve due to his left lower lobe atelectasis by an obstruction of left main bronchus. On day 9, interventional drainage of the major bronchus by disposable bronchoscopy was performed and built-up cast was removed by suctioning under the endoscopy. After the procedure, respiratory condition remarkably improved and he was extubated on day 14. COVID-19 infection with severe acute respiratory failure need mechanical ventilation support and if major airway obstruction was suspected, immediate interventional drainage may drastically change the patient clinical course and outcome.