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Unusual airways management during one-lung ventilation in thoracic surgery.

Authors
  • Primieri, Paolo1
  • Ancona, Paolo1
  • Gualtieri, Elisabetta1
  • 1 Department of Anesthesiology and Intensive Care, Catholic University of Rome, Rome, Italy. , (Italy)
Type
Published Article
Journal
Saudi Journal of Anaesthesia
Publisher
Medknow Publications
Publication Date
Jan 01, 2017
Volume
11
Issue
2
Pages
225–227
Identifiers
DOI: 10.4103/1658-354X.203015
PMID: 28442965
Source
Medline
Keywords
License
Unknown

Abstract

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.

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