TITLE:
Bradycardia Secondary to Negative Suction Pressure Applied to Chest Drain
AUTHORS:
Sanjeev Arya, Shantanu Belwal, Sanjay Saxena, Bhupesh Uniyal
KEYWORDS:
Chest Drain, High Negative Pressure, Bradycardia, Pleural Traction, Vagal Stimulation
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.8 No.8,
August
15,
2019
ABSTRACT: Positive pressure generated in peritoneal cavity by gas insufflation during laparoscopic procedures can cause hemodynamic instability. There are a few case reports suggesting similar occurrences during thoracoscopic procedures as well. The mechanism behind the conditions above is explained to be due to stretch force applied to peritoneum and pleura which causes vagal stimulation. We wish to present a case where a high negative pressure applied to pleural cavity lead to treatment-resistant bradycardia. The possible mechanism behind this occurrence was traction pressure on pleura which triggered vagal activity. The bradycardia subsided on reducing or discontinuing negative suction pressure. To best of our knowledge this the first case report on bradycardia associated with high negative suction pressure applied to inter costal drain.