The Cohen Flexitip Endobronchial Blocker: An Alternative to a Double Lumen Tube

Abstract

One-lung ventilation (OLV) is usually achieved by the use of a double-lumen tubes (DLTs). With increasing need for use of OLV for video-assisted thoracoscopic procedures, the limitations of traditional DLT's, including difficult insertion and positioning, have become evident. This has led to renewed interest in devising alternative methods of achieving lung separation, such as the Univent tube or Arndt endobronchial blocker. This report describes the technical features and clinical use of a new tip-deflecting endobronchial blocker.

Accidental fracture of the tip of the Coopdech bronchial blocker during insertion for one lung ventilation

“…It has a central aperture for limited suctioning and oxygenation plus a multiport adaptor for simultaneous fibreoptic bronchoscopy. 11 In inexperienced hands, it can be difficult to maneuver the blocker into the desired bronchus, as the wheel mechanism creates a large curvature rather than an angulation. 12 The Univent tube has been in use long before the Fuji and Coopdech blockers.…”

Sequential lobar-lung-lobar isolation using a deflecting tip bronchial blocker

“…The recently introduced Cohen flexitip endobronchial blocker (Cook Group, Inc) has potential advantages, especially when BB repositioning is indicated and if the patient is in the lateral position [6]. Sequential lobar-lunglobar isolation was easily performed as a result of the controlled deflecting properties of the distal tip.…”

One-Lung Ventilation in Anesthesia

“…Of these three devices, the Arndt blocker is available in 7 and 5 French for small adults and pediatrics; it uses a wire-guided mechanism [ 17 ]. The Cohen blocker possesses a rotating wheel that allows it to fl ex the tip of the blocker [ 5 ]. Both blockers use a multiport adapter.…”