From the Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, Maryland.
Departments of Anesthesiology.
A A Pract. 2022 May 1;16(5):e01586. doi: 10.1213/XAA.0000000000001586.
One-lung ventilation (OLV) can be accomplished utilizing a double-lumen tube (DLT) and an endobronchial blocker (EBB) or intentionally placing a standard endotracheal tube (ETT) into a mainstem bronchus. However, secondary options must be available should the primary method fail. We present a case where an EBB and a fiberoptic bronchoscope (FOB) were successfully passed through a left-sided DLT to reestablish right-lung isolation after the DLT bronchial cuff was surgically damaged. We advocate competency in placing both DLTs and EBBs, as well as having EBBs readily accessible as a secondary isolation method during OLV.
单肺通气(OLV)可以通过双腔管(DLT)和支气管内阻塞器(EBB)来实现,或者将标准的气管内导管(ETT)故意插入主支气管。然而,如果主要方法失败,必须有备用的次要方法。我们报告了一例病例,在左侧 DLT 的支气管套囊被手术损伤后,通过 EBB 和纤维支气管镜(FOB)成功地穿过左侧 DLT,重新建立了右侧肺隔离。我们主张有能力放置 DLT 和 EBB,并将 EBB 作为 OLV 期间的次要隔离方法随时备用。