Unusual airways management during one-lung ventilation in thoracic surgery

Airways management in thoracic surgery is usually more difficult than in other surgery. We reported a case of a patient who underwent surgery of evacuation of empyema where after a correct insertion of a left double-lumen tube 37 Fr (DLT), one-lung ventilation was not permitted by the high airways p...

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Bibliographic Details
Published in:Saudi journal of anaesthesia 2017-04, Vol.11 (2), p.225-227
Main Authors: Primieri, Paolo, Ancona, Paolo, Gualtieri, Elisabetta
Format: Article
Language:English
Subjects:
Arndt bronchial blocker
double-lumen tube
One-lung ventilation
Case Report
Intubation
Surgeons
Surgery
Thoracic surgery
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Summary:Airways management in thoracic surgery is usually more difficult than in other surgery. We reported a case of a patient who underwent surgery of evacuation of empyema where after a correct insertion of a left double-lumen tube 37 Fr (DLT), one-lung ventilation was not permitted by the high airways pressure. In fact, the hole of bronchial tip was just against the left bronchial wall retracted probably from inflammatory process. We introduced blindly an Arndt blocker 9 Fr inside the tracheal lumen of DLT until the orifice of the right upper lobe bronchus, the distance was checked before. After the positioning of the blocker, the DLT was pulled up to above the carina, and the single-lung ventilation was permitted. Sometimes, an unusual use of different devices permits to manage complications. In fact, in this case, the Arndt bronchial blocker helps us to solve an important ventilatory problem.
ISSN:1658-354X
0975-3125
DOI:10.4103/1658-354X.203015