Lung isolation techniques for patients with difficult airway

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.

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Lung Isolation Techniques in Patients With Early-Stage or Long-Term Tracheostomy: A Case Series Report of 70 Cases and Recommendations

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2018.05.033 ◽

2019 ◽

Vol 33 (2) ◽

pp. 433-439 ◽

Cited By ~ 5

Author(s):

Javier H. Campos ◽

Eli D. Musselman ◽

Satoshi Hanada ◽

Kenichi Ueda

Keyword(s):

Early Stage ◽

Case Series ◽

Lung Isolation ◽

Isolation Techniques ◽

Case Series Report ◽

Series Report

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National survey on lung isolation techniques

European Journal of Anaesthesiology ◽

10.1097/00003643-201006121-00803 ◽

2010 ◽

Vol 27 ◽

pp. 249

Author(s):

K. Nyangoni ◽

S. Balachandran ◽

I. Hodzovic

Keyword(s):

National Survey ◽

Lung Isolation ◽

Isolation Techniques

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Congenital Pulmonary Airway Malformation

10.1093/med/9780190685157.003.0015 ◽

2018 ◽

Author(s):

Alina Lazar

Keyword(s):

Thoracic Surgery ◽

Anesthetic Management ◽

Lung Ventilation ◽

Cardiovascular Complications ◽

Positive Pressure ◽

Clear Understanding ◽

One Lung Ventilation ◽

Lung Isolation ◽

Isolation Techniques ◽

Lung Abnormalities

Respiratory distress in infants may be caused by perinatal events and physiologic changes (e.g., lung immaturity, meconium aspiration, and persistent pulmonary hypertension); infectious processes; cardiovascular, neurologic, and metabolic abnormalities; as well as congenital lung abnormalities. Some of these may coexist, further complicating the diagnosis, clinical course, and management of the affected infant. Sound anesthetic management of congenital lung abnormalities requires a clear understanding of the pathophysiology of lung lesions and, in particular, the consequences of positive-pressure ventilation in patients with cystic and emphysematous lesions. Also critical is an appreciation for the physiologic differences in children undergoing thoracic surgery, indications for one-lung ventilation, age-appropriate lung isolation techniques, potential respiratory and cardiovascular complications that may occur during pediatric thoracic surgery, and the optimal choices for postoperative analgesia.

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