Sodium Bicarbonate Irrigation for Dissolving Obstructive Bronchial Clots in a Polytrauma Patient: A Case Report

Abstract

The management of bronchial clots in polytrauma patients remains challenging, with limited efficacy of current methods. This case report details the successful use of sodium bicarbonate (NaHCO₃) irrigation to dissolve obstructive bronchial clots in a 27-year-old male with ARDS secondary to trauma. Pre-intervention, the patient exhibited severe hypoxemia with a P/F ratio of 50, requiring FiO₂ 60% and PEEP 10 cmH₂O. Bronchoscopic irrigation with 8.4% NaHCO₃ dissolved organized clots resistant to saline lavage, facilitating their removal. Within 48 hours, oxygenation improved significantly, with a P/F ratio rising to 230. By day 11, the patient was successfully extubated and maintained stable respiratory parameters. This case highlights the potential utility of NaHCO₃ in addressing complex respiratory complications, warranting further research.