Utilization of an Endobronchial Blocker Through a Double-Lumen Tube as Rescue for Inadequate One-Lung Ventilation

Abstract

Failure to provide one-lung ventilation can prohibit minimally invasive thoracic surgeries. Strategies for one-lung ventilation include double-lumen endotracheal tubes or endobronchial blockers, but rarely both. Inability to provide lung isolation after double-lumen endotracheal tube placement requires troubleshooting and sometimes the use of extra equipment. This case describes using a unique Y-shaped endobronchial blocker placed through a left-sided double-lumen endotracheal tube after failure to achieve lung isolation with a double-lumen endotracheal tube alone.

Understanding Physiology and Using Technology to Care for Challenging Patients

“…This technique was used to avoid general anesthesia and the sequelae of positive pressure ventilation in a patient with severe cardiopulmonary failure awaiting simultaneous heart and lung transplantation. The second case 20 describes the tribulations that can often be encountered while attempting to provide adequate lung isolation for minimally invasive thoracic surgeries. Common approaches include double-lumen endotracheal tubes, or the use of an endobronchial blocker placed through a single-lumen endotracheal tube.…”