scholarly journals Providing one-lung ventilation in posttracheostomic tracheal stenosis for thoracoscopic plastic of the right diaphragm dome

2021 ◽  
Vol 18 (5) ◽  
pp. 76-81
Author(s):  
D. G. Kabakov ◽  
A. Yu. Zaytsev ◽  
M. A. Vyzhigina ◽  
K. V. Dubrovin ◽  
G. A. Kazaryan ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Tracheal Stenosis ◽  
Main Bronchus ◽  
Prolonged Mechanical Ventilation ◽  
Nasotracheal Intubation ◽  
Lung Ventilation ◽  
High Frequency Ventilation ◽  
One Lung Ventilation ◽  
Grade 3 ◽  
The Right

The article is devoted to the consideration of a clinical case of providing artifcial one-lung ventilation for performing thoracoscopic plastic of the right dome of the diaphragm in a patient with grade 3 posttracheostomy cicatricial tracheal stenosis. The patient is presented after a new coronavirus infection COVID-19 from 2020, prolonged mechanical ventilation through a tracheostomy tube (74 days), the development of medium thoracic cicatricial tracheal stenosis of grade 3 (the lumen of the narrowest part of the trachea is 4 mm) after decannulation and the development of relaxation of the right dome of the diaphragm (according to CT data, the dome is located at the level of the IV intercostal space). The frst stage under conditions of combined general anesthesia and high-frequency ventilation of the lungs was performed to restore the lumen of the trachea by bougienage of the stenosis area with tubes of a rigid endoscope under the control of a fberoptic bronchoscope with further nasotracheal intubation with a thermoplastic single-lumen endotracheal tube with a diameter of 8.0 with a cuff. At the second stage, during thoracoscopic plastic of the right dome of the diaphragm, to provide artifcial one-lung ventilation, a bronchial blocker was used, introduced through the same endotracheal tube into the right main bronchus under the control of a fberoptic bronchoscope.

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.

scholarly journals Mucosal Changes in the Trachea and Main Bronchi of Newborn Infants after Nasotracheal Intubation

1975 ◽  
Vol 3 (3) ◽  
pp. 209-217 ◽  
Author(s):  
G. C. Fisk ◽  
W. de C. Baker
Keyword(s):  
Endotracheal Tube ◽  
Main Bronchus ◽  
Squamous Metaplasia ◽  
Nasotracheal Intubation ◽  
Newborn Infants ◽  
Respiratory Epithelium ◽  
Lower Trachea ◽  
Nasotracheal Tube ◽  
Mucosal Changes ◽  
The Right

Permanent sequelae of nasotracheal intubation are uncommon, but acute ulceration and squamous metaplasia occur. Histological sections from the trachea and main bronchi were examined in 12 infants. A nasotracheal tube had been inserted during the first two weeks of life of these infants and had been in place for more than one week. In four cases the patient died some time (7 to 108 days) after extubation. Similar sections from patients who were not intubated, intubated only for attempted resuscitation, or intubated for several hours were studied for comparison. The sections were classified according to the degree of mucosal loss and metaplasia, and the extent of the lesions was estimated. Squamous change was seen in most sections from all 12 patients with the exception of one who died 57 days after extubation. Some respiratory epithelium was seen in all patients. In the eight patients who died while intubated, the changes were more marked in the right main bronchus than the left in seven, and more marked in the lower trachea than the upper in five. In the two patients intubated for several hours, in addition to mucosal loss, early metaplasia was seen. It is suggested that mucosal loss is replaced by the squamous metaplasia, and that trauma caused by suction catheters in the lower trachea and right main bronchus is more extensive than that due to the endotracheal tube itself.

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.

The “Spacemaker”, a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study

2015 ◽  
Vol 10 (4) ◽  
pp. 241-247
Author(s):  
Pieter W.J. Lozekoot ◽  
Sandro Gelsomino ◽  
Paul B. Kwant ◽  
Orlando Parise ◽  
Francesco Matteucci ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Lung Tissue ◽  
Lung Ventilation ◽  
Cardiothoracic Surgery ◽  
Respiratory Compromise ◽  
One Lung Ventilation ◽  
New Device ◽  
Lead Placement ◽  
The Right

Objective Our aim was to evaluate a new inflatable lung retractor, the “Spacemaker”, and its efficacy in facilitating minimally invasive cardiothoracic surgery without the need of one lung ventilation or carbon dioxide overpressure insufflation. Methods The device was tested in 12 anesthetized pigs (90–100 kg) placed on standard endotracheal ventilation. The device was introduced into the right or left side of the chest, depending on the intended procedure to be performed, via a 3-cm incision in the fifth intercostal space. A total of seven animals were used to evaluate hemodynamic and respiratory response to the device, whereas another five animals were used to assess the feasibility of a variety of minimally invasive cardiothoracic surgical procedures. Results Introduction was easy and unhindered. The device was inflated up to 0.6 bar, thereby pushing the lung tissue gently away cranially, posteriorly, and caudally without interfering with pulmonary function or resulting in respiratory compromise. In addition, hemodynamics remained stable throughout the experiments. Different closed-chest surgical procedures such as left atrial appendage exclusion, pulmonary vein exposure, pacemaker lead placement, and endoscopic stabilization for coronary surgery, were successfully performed. Removal was quick and complete in all cases, and lung tissue showed no remnant atelectasis. Conclusions The “Spacemaker” may represent a reliable alternative to current conventional techniques to facilitate minimally invasive cardiothoracic surgery. Further research is warranted to confirm the effectiveness and the safety of this device and to optimize the model before its use in humans and its introduction into clinical practice.

scholarly journals One lung ventilation in thoracic esophageal operation: Clinical experience using endotracheal tube with movable blocker.

1985 ◽  
Vol 18 (7) ◽  
pp. 1595-1599 ◽  
Author(s):  
Takashi SUGIHARA ◽  
Hiroyasu MAKUUCHI ◽  
Tetsuji SASAKI ◽  
Tomoo TAJIMA ◽  
Toshio MITOMI ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Clinical Experience ◽  
Lung Ventilation ◽  
One Lung Ventilation

scholarly journals A rare anaesthetic challenge in a one-lung ventilated paediatric patient with right upper lobe tracheal bronchus

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096760
Author(s):  
Yuangui Zhang ◽  
Meiman Qin ◽  
Xiaoqian Wang ◽  
Quanzhang Yan
Keyword(s):  
Paediatric Patient ◽  
Left Lung ◽  
Recurrent Infection ◽  
Lung Ventilation ◽  
Tracheal Bronchus ◽  
One Lung Ventilation ◽  
Recurrent Pneumonia ◽  
Single Lumen ◽  
History Of ◽  
The Right

A tracheal bronchus is a rare congenital anomaly, suggesting abnormal bronchial development. The prevalence of tracheal bronchus in children who undergo bronchoscopy is estimated to be between 0.2% and 3%. When associated with recurrent infection, lobes of the lung must be removed to avoid further lung injury. In such cases, perioperative one-lung ventilation and airway management remain a huge challenge for anaesthesiologists. The case of this rare airway anatomic abnormality in a paediatric patient with two bronchial openings into the right upper lobe, and with a history of recurrent pneumonia, is reported. In addition to a normal opening, a distinct opening in the upper lobe of the right lung was observed, that originated directly from the trachea, superior to the carina. The entire right lung was deflated by left-lung ventilation using a single lumen tracheal tube, and the patient underwent right upper lobe resection. No anaesthesia complications were observed during recovery. In this case, timely identification of the tracheal bronchus and successful collapse of the right lung were key points in the anaesthesia management of this patient.

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