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Lung Isolation in Patients with Difficult Airways

  • Daniel Tran
  • Wanda M. PopescuEmail author
Chapter

Abstract

Recognition of a difficult airway prior to the use of lung isolation devices is essential. Radiological studies must be reviewed, including a posterior–anterior chest radiograph and computer tomography scan of the chest. Securing the airway first is a must in patients with difficult airways requiring lung isolation. The use of an independent bronchial blocker is the first-line choice in patients with difficult airways who require lung isolation. The use of the airway exchange catheter is recommended during placement of double-lumen endotracheal tubes in patients with difficult airways.

Keywords

Difficult airway One-lung ventilation Lung isolation Tracheostomy 

Supplementary material

Video 18.1

A patient with a non-cuffed Shiley tracheostomy presents for thoracic surgery requiring lung isolation. A Cook airway catheter is placed through the Shiley tracheostomy. The Shiley is removed, and a single-lumen 8.0-mm tube is placed over the exchange catheter. A 9.0 F Fuji Uniblocker is placed in the desired mainstem bronchus under flexible bronchoscopic guidance. Suction is attached to the end of the bronchial blocker to facilitate lung deflation (MP4 145537 kb)

Video 18.2

The bronchial blocker cuff is inflated under direct bronchoscopic view to confirm complete bronchial occlusion (MP4 258730 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of AnesthesiologyYale School of MedicineNew HavenUSA

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