The wire-guided endobronchial blocker as a solution to provide one-lung ventilation when a double-lumen endotracheal tube is malpositioned

2003 ◽  
Vol 17 (5) ◽  
pp. 636-637 ◽  
Author(s):  
Guy Kuhlman ◽  
Christophe Legros ◽  
Pierre-Antoine Laloë ◽  
Philippe Puyo ◽  
Marc Fischler
Keyword(s):  
Endotracheal Tube ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Double Lumen Endotracheal Tube ◽  
Endobronchial Blocker ◽  
The Wire

scholarly journals One Lung Ventilation Using an Orotracheal Tube and an Endobronchial Blocker in a Patient with Difficult Airway

2021 ◽  
Author(s):  
PA Sahana ◽  
Pooja Rao ◽  
Gururaj Tantry ◽  
Thrivikrama Padur Tantry
Keyword(s):  
Difficult Airway ◽  
Mouth Opening ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Double Lumen Endotracheal Tube ◽  
Lung Isolation ◽  
Isolation Techniques ◽  
Orotracheal Tube ◽  
Endobronchial Blocker

One-Lung Ventilation (OLV) is achieved in thoracic surgeries to facilitate collapse of one lung for better surgical visualisation. Double-lumen tubes and bronchial blockers are two commonly used devices for OLV. Patients with ‘difficult airway’ pose significant challenges for insertion of Double Lumen Endotracheal Tube (DLT). Dual malignancy such as carcinoma of lung and head and neck is extremely rare to present with. Patients presenting with restricted mouth opening due to previous surgeries and requiring lung isolation techniques may pose significant challenges to anaesthesiologist. The difficult airway scenario may arise in such patients owing to their previous surgery to the tongue, larynx, neck, mandible or previous radiation. The present case was of 47-year-old of lung isolation achieved in a patient with restricted mouth opening with an orotracheal tube, bougie, endobronchial blocker and a flexible Fibre Optic Bronchoscope (FOB). Left upper lobectomy was successfully performed after passing endobronchial blocker through a conventional orotracheal tube under the guidance of FOB.

scholarly journals Successful one-lung ventilation by blocking the right intermediate bronchus in a 7-year-old child: a case report

2019 ◽  
Vol 47 (6) ◽  
pp. 2740-2745
Author(s):  
Seung Youp Baek ◽  
Jin Hwan Kim ◽  
Goo Kim ◽  
Jin Ho Choi ◽  
Chang Young Jeong ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Main Bronchus ◽  
Left Lung ◽  
Lung Ventilation ◽  
Surgical Excision ◽  
One Lung Ventilation ◽  
Lower Lung ◽  
Endobronchial Blocker ◽  
Surgical Field ◽  
The Right

A 7-year-old child underwent surgical excision of a benign mesothelioma of the pleura near the right lower lung. Although insertion of a wire-reinforced endotracheal tube through the left main bronchus was attempted for one-lung ventilation to secure the surgical field of view, the attempt failed. Therefore, an endotracheal tube was inserted into the trachea, and an Arndt endobronchial blocker (Cook Medical, Bloomington, IN, USA) was placed in the right intermediate bronchus under bronchoscopic guidance to selectively block the right lower and middle lobes. The surgery was performed while ventilating the right upper lobe and left lung, and no specific intraoperative adverse events occurred.

Airway Injuries after One-lung Ventilation: A Comparison between Double-lumen Tube and Endobronchial Blocker

2006 ◽  
Vol 105 (3) ◽  
pp. 471-477 ◽  
Author(s):  
Heike Knoll ◽  
Stephan Ziegeler ◽  
Jan-Uwe Schreiber ◽  
Heiko Buchinger ◽  
Patric Bialas ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Sore Throat ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
Cumulative Number ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lumen Tube ◽  
Endobronchial Blocker ◽  
The Impact

Background Vocal cord injuries, postoperative hoarseness, and sore throat are common complications after general anesthesia. One-lung ventilation can be achieved via two techniques: double-lumen endotracheal tube or endobronchial blocker such as the Arndt blocker. The current study was designed to assess the impact of these techniques for one-lung ventilation on the incidence and severity of postoperative hoarseness, vocal cord lesions, and sore throat. Methods In this prospective trial, 60 patients were randomly assigned to two groups. One-lung ventilation was achieved with either an endobronchial blocker (blocker group) or a double-lumen-tube (double-lumen group). Postoperative hoarseness and sore throat were assessed at 24, 48, and 72 h after surgery. Bronchial injuries and vocal cord lesions were examined by bronchoscopy immediately after surgery. Results In 56 included patients, postoperative hoarseness occurred significantly more frequently in the double-lumen group compared with the blocker group: 44% versus 17%, respectively (P = 0.046). Similar findings were observed for vocal cord lesions: 44% versus 17%, respectively (P = 0.046). The incidence of bronchial injuries was comparable between groups (P = 0.540). Cumulative number of days with hoarseness and sore throat were significantly increased in the double-lumen group compared with the blocker group (P < 0.01). No major complications such as bronchial ruptures were observed. Conclusions Clinicians should be aware of an increased incidence of minor airway injuries that may impair patient satisfaction when using a double-lumen tube instead of an endobronchial blocker for one-lung ventilation.

scholarly journals Difficult Management of a Double-Lumen Endotracheal Tube and Difficult Ventilation during Robotic Thymectomy with Carbon Dioxide Insufflation

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Yuki Sugiyama ◽  
Kunihiro Mitsuzawa ◽  
Yuki Yoshiyama ◽  
Fumiko Shimizu ◽  
Satoshi Fuseya ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Endotracheal Tube ◽  
Intraoperative Complications ◽  
Lung Ventilation ◽  
Double Lumen ◽  
Double Lumen Endotracheal Tube ◽  
Lung Expansion ◽  
Distal Migration ◽  
Difficult Ventilation ◽  
Robotic Thymectomy

Robotic surgery with carbon dioxide (CO2) insufflation to the thorax is frequently performed to gain a better operative field of view, although its intraoperative complications have not yet been discussed in detail. We treated two patients with difficult ventilation caused by distal migration of a double-lumen endotracheal tube (DLT) during robotic thymectomy. In the first case, migration of the DLT during one-lung ventilation (OLV) occurred after CO2 insufflation to the bilateral thoraxes was started. Oxygenation rapidly deteriorated because dependent lung expansion was restricted by CO2 insufflation. In the second case, migration of the DLT during OLV occurred while CO2 insufflation to a unilateral thorax and mediastinum was performed. In both cases, once migration of the DLT during OLV occurred with CO2 insufflation, readjusting the DLT became very difficult because our manipulation of bronchofiberscopy was prevented by the robot arms located above the patient’s head and because deformation of the trachea/bronchus induced by CO2 insufflation caused a poor image of the bronchofiberscopic view. Thus, during robotic-assisted thoracoscopic surgery with CO2 insufflation, since there is a potential risk of difficult ventilation with a DLT and since readjustment of the DLT is very difficult, discontinuing CO2 insufflation and switching to double-lung ventilation are needed in such a situation.

scholarly journals An alternative for one lung ventilation in an adult horse requiring thoracotomy

2012 ◽  
Vol 81 (2) ◽  
pp. 98-101
Author(s):  
M. Gozalo-Marcilla ◽  
S. Schauvliege ◽  
S. Torfs ◽  
M. Jordana
Keyword(s):  
Endotracheal Tube ◽  
Surgical Procedure ◽  
Main Bronchus ◽  
Lung Ventilation ◽  
Left Main Bronchus ◽  
Left Main ◽  
One Lung Ventilation ◽  
Endoscopic Guidance ◽  
Endobronchial Blocker

In order to provide one lung ventilation in an anesthetized adult horse undergoing thoracoscopy and exploratory thoracotomy, an alternative to the described techniques was developed using a homemade endobronchial blocker construction. An orifice (with a diameter of 1 cm) was made 15 cm distally to the proximal end of a standard 28 mm ID endotracheal tube (ETT) allowing the placement of a standard broncho-alveolar catheter. The adapted ETT was advanced up to the larynx in the anesthetized horse. Prior to the intubation of the trachea, the broncho-alveolar catheter was passed through the ETT and positioned into the left main bronchus under endoscopic guidance. If it would have been required, the cuff of the broncho-alveolar catheter could have been inflated, allowing OLV. However, one lung ventilation was not required during the surgical procedure.

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