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

Chennakeshavallu, G N; Sruthi, S

doi:10.4103/ija.ija_299_20

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…Multiple techniques for manipulation of the airway and preventing aspiration during TEF repair with and without lung isolation are found in the literature. Chennakeshavallu and Sruthi 10 report retracting a left-sided DLT to accommodate an EBB through the bronchial lumen into the left mainstem to regain left-lung isolation. The difference in this case was that the patient remained in stable condition throughout due to a small leak, allowing for a more purposeful approach.…”

Section: Discussionmentioning

confidence: 99%

Maintaining One-Lung Ventilation With an Endobronchial Blocker Through a Damaged Left-Sided Double-Lumen Tube: A Case Report

et al. 2022

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One-lung ventilation (OLV) can be accomplished utilizing a double-lumen tube (DLT) and an endobronchial blocker (EBB) or intentionally placing a standard endotracheal tube (ETT) into a mainstem bronchus. However, secondary options must be available should the primary method fail. We present a case where an EBB and a fiberoptic bronchoscope (FOB) were successfully passed through a left-sided DLT to reestablish right-lung isolation after the DLT bronchial cuff was surgically damaged. We advocate competency in placing both DLTs and EBBs, as well as having EBBs readily accessible as a secondary isolation method during OLV.

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Section: Discussionmentioning

confidence: 99%

Maintaining One-Lung Ventilation With an Endobronchial Blocker Through a Damaged Left-Sided Double-Lumen Tube: A Case Report

et al. 2022

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“…In recent literature, the use of a bronchial blocker in a prone position has also been observed [ 6 ]. Another rare use of a bronchial blocker has been reported as an aid for a malfunctioned bronchial cuff in a DLT [ 7 ]. Moreover, the bronchial blocker has also proved to be a lifesaving tool in fatal bleeds from the respiratory tract [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Use of an Endobronchial Blocker Where a Double-Lumen Tube Failed to Ventilate: A Case Report of a Distorted Tracheobronchial Anatomy

Amjad¹,

Khan²,

Khan³

2022

Cureus

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One-lung ventilation (OLV) during video-assisted thoracoscopic surgery (VATS) can be accomplished through several different techniques, including bronchial advancement of an endotracheal tube (ETT), use of a double-lumen tube (DLT), or placement of an endobronchial blocker. In most cases, a DLT is a mainstay of isolating and ventilating a single lung during cardiothoracic procedures. The reasons to deploy a DLT over other techniques include ease of placement, less chance of malposition, quick placement time, and quality of lung deflation. However, this case report highlights the importance of a bronchial blocker in a patient where a double-lumen tube failed to ventilate the lungs. Briefly, this young female patient had a right thoracic mass associated with ipsilateral lung collapse and moderate pleural effusion. CT-guided biopsy was planned but was deferred by the radiologist, as the patient was unable to lie in a prone position. The case was then referred to the cardiothoracic surgeon who planned a right VATS and biopsy of the lesion. In the operation theater, after induction of anesthesia, the patient could not be ventilated through a DLT, and high peak airway pressures were encountered. Initially, a size 37 left-sided DLT was used, and subsequently, sizes 35, 32, and 28 were also tried, but all these attempts to ventilate the patient remained futile. A bronchoscopy was done, which did not show any abnormality in the airway. The surgery was postponed due to an inability to ventilate the patient with a double-lumen tube. After a repeat CT scan and draining of 9.3 liters of pleural effusion over a week, the patient was again scheduled for the same procedure but with a changed anesthetic plan. This time around, the anesthetic plan was implemented successfully using a bronchial blocker to isolate the right lung. The surgery went ahead, and the patient had an uneventful postoperative period. The anesthetic management of this patient presented a unique set of challenges, which are shared in this case report.

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“…The combined use of DLT and BB has been reported by various authors in the past, to combat hypoxia, prevent contamination of the lung, or rectify the endobronchial cuff malfunction, mainly as a ‘rescue’ method during surgery. [ 2 - 5 ]…”

mentioning

confidence: 99%

A Comment on- A New Strategy in Lung/Lobe Isolation in Patients with a Lung Abscess or a Previous Lung Resection Using Double Lumen Tubes Combined with Bronchial Blockers’

Parab

2023

Annals of Cardiac Anaesthesia

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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

Cited by 4 publications

References 4 publications

Maintaining One-Lung Ventilation With an Endobronchial Blocker Through a Damaged Left-Sided Double-Lumen Tube: A Case Report

Maintaining One-Lung Ventilation With an Endobronchial Blocker Through a Damaged Left-Sided Double-Lumen Tube: A Case Report

Use of an Endobronchial Blocker Where a Double-Lumen Tube Failed to Ventilate: A Case Report of a Distorted Tracheobronchial Anatomy

A Comment on- A New Strategy in Lung/Lobe Isolation in Patients with a Lung Abscess or a Previous Lung Resection Using Double Lumen Tubes Combined with Bronchial Blockers’

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