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

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

Journal of International Medical Research ◽

10.1177/0300060519845782 ◽

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.

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Successful anesthetic management in a child after traumatic rupture of left main bronchus by a single-lumen cuffed-endotracheal tube

Annals of Cardiac Anaesthesia ◽

10.4103/0971-9784.142066 ◽

2014 ◽

Vol 17 (4) ◽

pp. 292 ◽

Cited By ~ 1

Author(s):

Hamed Elgendy ◽

Tariq Jilani

Keyword(s):

Endotracheal Tube ◽

Main Bronchus ◽

Anesthetic Management ◽

Left Main Bronchus ◽

Traumatic Rupture ◽

Left Main ◽

Cuffed Endotracheal Tube ◽

Single Lumen

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Iatrogenic Left Main Bronchus Injury following Atraumatic Double Lumen Endotracheal Tube Placement

Case Reports in Anesthesiology ◽

10.1155/2013/524348 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3

Author(s):

William R. Hartman ◽

Michael Brown ◽

James Hannon

Keyword(s):

Endotracheal Tube ◽

Main Bronchus ◽

Left Main Bronchus ◽

Double Lumen Tube ◽

Tube Placement ◽

Left Main ◽

Double Lumen ◽

Lumen Tube ◽

Double Lumen Endotracheal Tube ◽

Endotracheal Tube Placement

Tracheobronchial disruption is an uncommon but severe complication of double lumen endotracheal tube placement. The physical properties of a double lumen tube (large external diameter and length) make tracheobronchial injury more common than that associated with smaller single lumen endotracheal tubes. Here we present the case of an iatrogenic left main bronchus injury caused by placement of a double lumen tube in an otherwise unremarkable airway.

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

Messenger of Anesthesiology and Resuscitation ◽

10.21292/2078-5658-2021-18-5-76-81 ◽

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.

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Velocity profiles in central airways with endotracheal intubation: a model study

Journal of Applied Physiology ◽

10.1152/jappl.1986.60.3.876 ◽

1986 ◽

Vol 60 (3) ◽

pp. 876-884 ◽

Cited By ~ 2

Author(s):

A. S. Menon ◽

M. E. Weber ◽

H. K. Chang

Keyword(s):

Endotracheal Tube ◽

Endotracheal Intubation ◽

Particle Deposition ◽

Main Bronchus ◽

Velocity Profiles ◽

Left Main Bronchus ◽

Scale Model ◽

Left Main ◽

Lobar Bronchus ◽

The Right

Steady inspiratory velocity profiles were measured at two flow rates in a 3:1 scale model of the human central airways in the presence of five modes of endotracheal intubation. The presence of an orifice or a short endotracheal tube had no significant effect on the velocity profiles distal to the carina. Long endotracheal tubes change the profiles in both main bronchi. A significant peak occurred in the frontal plane near the walls, and the maximum velocity in the airway was almost identical to the endotracheal tube center-line velocity. The flow impinging on the medial wall of the main bronchus was redirected up around the anterior and posterior walls yielding bipeak velocity profiles in the sagittal plane. A tube placed eccentrically in the trachea over the right main bronchus did not alter the velocity profiles in the left main bronchus, suggesting a redirection of flow over the carina into the left lung. An endobronchial tube at the mouth of the right main bronchus did change the shape of the velocity profiles in the left main bronchus. In the left upper lobar bronchus the presence of trachea intubation had no effect on the velocity profiles. However, in the right upper lobar bronchus, the long endotracheal tube flattened the velocity profiles from the strongly skewed ones seen in the absence of the endotracheal inserts. These results not only are relevant to distribution of ventilation and aerosol particle deposition, but also have strong implications in intrapulmonary gas mixing, especially when high-frequency low tidal-volume ventilation is involved.

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