Kawagoe Izumi, Hayashida Masakazu, Satoh Daizoh, Suzuki Kenji, Inada Eiichi
Division of General Thoracic Anesthesia, Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan.
, Tokyo, Japan.
JA Clin Rep. 2018 Jun 21;4(1):51. doi: 10.1186/s40981-018-0188-8.
Ventilation failure commonly occurs when a standard left-sided double-lumen tube is used in patients after left upper lobectomy having remarkable angulation of the left main bronchus. We present a female without remarkable angulation, in whom ventilation failure occurred after lateral jackknife positioning.
A 73-year-old female after lingula-sparing left upper lobectomy without remarkable angulation was scheduled for robot-assisted right upper lobectomy. Ventilation failure with a standard left-sided double-lumen tube occurred when she was placed not in the lateral position but in the lateral jackknife position required for robotic surgery. After replacement by the Silbroncho® left-sided double-lumen tube, adequate one-lung ventilation became possible.
Ventilation failure with a standard tube may occur more easily when patients with bronchial angulation are placed in the lateral jackknife than lateral position due to posture-induced exacerbations of bronchial angulation. The Silbroncho® tube seems useful in such situations.
当标准的左侧双腔管用于左上叶切除术后左主支气管有明显成角的患者时，通气失败很常见。我们报告一例左主支气管无明显成角的女性患者，其在侧卧位折刀位摆放后发生了通气失败。
一名73岁女性，行保留舌叶的左上叶切除术后，左主支气管无明显成角，计划行机器人辅助右上叶切除术。当她不是处于侧卧位而是处于机器人手术所需的侧卧位折刀位时，使用标准左侧双腔管出现了通气失败。更换为Silbroncho®左侧双腔管后，实现了充分的单肺通气。
由于体位导致支气管成角加剧，支气管有角度的患者在侧卧位折刀位时可能比侧卧位更容易出现标准管通气失败。Silbroncho®管在这种情况下似乎有用。
