Khidr Alaa M, El Tahan Mohamed R
Department of Anesthesiology, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia.
Saudi J Anaesth. 2021 Jul-Sep;15(3):300-311. doi: 10.4103/sja.sja_1086_20. Epub 2021 Jun 19.
Difficult lung isolation or separation in patients undergoing thoracic surgery using one-lung ventilation might be attributed to upper airway difficulty or abnormal anatomy of the lower airway. Additionally, adequate deflation of the surgical lung can impair surgical exposure. The coronavirus disease 2019 (COVID-19) has a harmful consequence for both patients and anesthesiologists. Management of patients with difficult lung isolation can be challenging during the COVID-19 pandemic. Careful planning and preparation, preoperative routine testing, protective personal equipment, standard safety measures, proper preoxygenation, and individualize the patients care are required for successful lung separation. A systematic approach for management of difficult lung separation is centered around securing the airway and providing adequate ventilation using either a blocker or double-lumen tube. Several measures are described to expedite lung collapse.
在接受胸外科手术并使用单肺通气的患者中，困难的肺隔离或分离可能归因于上呼吸道困难或下呼吸道解剖结构异常。此外，手术侧肺的充分萎陷可能会影响手术视野。2019冠状病毒病（COVID-19）对患者和麻醉医生都有不良影响。在COVID-19大流行期间，管理困难肺隔离的患者可能具有挑战性。成功的肺分离需要精心规划和准备、术前常规检查、个人防护设备、标准安全措施、适当的预充氧以及个体化的患者护理。处理困难肺分离的系统方法围绕确保气道安全并使用封堵器或双腔管提供充分通气展开。文中描述了几种加速肺萎陷的措施。
