Response to “Data Interpretation on the Use of Double-Lumen Tube Versus Bronchial Blocker for One-Lung Ventilation”

Abstract Background: Intubation difficulties, hypoxemia, inability to perform a one-lung ventilation, and high airway pressure often occur during double-lumen tube intubation. Tracheal bronchus is a very rare and difficult to find reason. We present a case of tracheal bronchus accidentally discovered during double-lumen tube intubation in a patient undergoing thoracic surgery. We are the first one to summarize the one-lung ventilation strategy for patients with tracheal bronchus. Case Presentation: A 53-year-old man underwent a scheduled thoracoscopic left upper lobectomy. After two unsuccessful attempts to pass the right-sided double-lumen tube through the right mainstem bronchus, fiberoptic bronchoscopy revealed an aberrant tracheal bronchus with an incidence of 0.1%–3%. Finally we used a left-sided DLT to ventilate the right lung. The patient had no airway complications and was discharged 7 days after the operation.Conclusions: This case serves to remind us that preoperative visits must be thorough and careful. Although a computed tomography chest examination was performed before surgery, we just looked at the inspection report and did not look at the images. We also reviewed relevant literature and summarized the one-lung ventilation strategies for patients with tracheal bronchus. For left-lung ventilation, either a left-sided double-lumen tube or a combination of a bronchial blocker and Fogarty artery embolization catheter can be used. For right-lung ventilation, a bronchial blocker or a left-sided double-lumen tube is a good choice.

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Bronchial blocker as an aid in the management of endo-bronchial cuff malfunction of double-lumen tube during one-lung ventilation

Indian Journal of Anaesthesia ◽

10.4103/ija.ija_299_20 ◽

2020 ◽

Vol 64 (10) ◽

pp. 911

Author(s):

GN Chennakeshavallu ◽

S Sruthi

Keyword(s):

Lung Ventilation ◽

Double Lumen Tube ◽

Bronchial Blocker ◽

One Lung Ventilation ◽

Double Lumen ◽

Lumen Tube ◽

Bronchial Cuff

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Bronchial blocker compared to double-lumen tube for one-lung ventilation during thoracoscopy

Acta Anaesthesiologica Scandinavica ◽

10.1034/j.1399-6576.2001.450218.x ◽

2001 ◽

Vol 45 (2) ◽

pp. 250-254 ◽

Cited By ~ 14

Author(s):

C. Bauer ◽

C. Winter ◽

J. G. Hentz ◽

X. Ducrocq ◽

A. Steib ◽

...

Keyword(s):

Lung Ventilation ◽

Double Lumen Tube ◽

Bronchial Blocker ◽

One Lung Ventilation ◽

Double Lumen ◽

Lumen Tube

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Use of a Fogarty Catheter as a Bronchial Blocker through a Single-lumen Endotracheal Tube in Patients with Subglottic Stenosis

Anaesthesia and Intensive Care ◽

10.1177/0310057x0303100215 ◽

2003 ◽

Vol 31 (2) ◽

pp. 214-216 ◽

Cited By ~ 3

Author(s):

H. P. Park ◽

J. H. Bahk ◽

J. H. Park ◽

Y. S. Oh

Keyword(s):

Endotracheal Tube ◽

Lung Ventilation ◽

Subglottic Stenosis ◽

Double Lumen Tube ◽

Bronchial Blocker ◽

Fogarty Catheter ◽

One Lung Ventilation ◽

Double Lumen ◽

Lumen Tube ◽

Single Lumen

One-lung ventilation can be achieved with a double-lumen tube or a bronchial blocker. However, the larger outer diameters of double-lumen or Univent tubes may prevent their passage through an area of subglottic stenosiss. We present five cases of subglottic stenosis in which a Fogarty catheter was used as a bronchial blocker through a single-lumen endotracheal tube. The outer diameters of a double-lumen tube, Univent tube and single-lumen tube were compared. Despite special equipment designed for one-lung ventilation, the use of a bronchial blocker through a single-lumen tube, which has the thinnest available wall thickness, seems to be one of the most effective and safest ways of achieving one-lung ventilation in patients with subglottic stenosis or narrowing.

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