Abstract
Lung isolation techniques are used most commonly during the thoracic, cardiovascular, and other chest cavity procedures (mediastinal, esophageal, or orthopedic). Besides facilitating One-Lung Ventilation (OLV) and facilitating surgical exposure, it protects and prevents the soiling of lung by the contra-lateral lung especially in cases of whole-lung lavage, broncho-pleural fistula, and pulmonary hemorrhage. Lung isolation techniques are also used to provide differential patterns of ventilation in unilateral reperfusion injury (e.g., after lung-transplantation or pulmonary thrombo-endarterectomy) and in unilateral lung-trauma.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Campos JH. Progress in lung separation. Thorac Surg Clin. 2005;15:71.
American Society of Anesthesiologists. Practice guidelines for management of the difficult airway: an updated report. Anesthesiology. 2003;98:1269–77.
Brodsky JB, Adkins MO, Gaba DM. Bronchial cuff pressures of double-lumen tubes. Anesth Analg. 1989;69:608–10.
Cohen JA, Denisco RA, Richards TS, et al. Hazardous placement of a Robertshaw-type endobronchial tube. Anesth Analg. 1986;65:100–1.
Marasigan BL, Sheinbaum R, Hammer GB, et al. Separation of the two lungs. Benumof and Hagberg airway management; 2013. p. 549–68.
Neto PP. Bronchial cuff pressure of endobronchial double-lumen tubes. Anesth Analg. 1990;71:209.
Saracoglu A, Saracoglu KT. VivaSight: a new era in the evolution of tracheal tubes. J Clin Anesth. 2016;33:442–9.
Slinger PD, Campos JH. Anesthesia for thoracic surgery. Miller’s anesthesia, 7th edn. Churchill Livingstone, Philadelphia; 2009.
Yasumoto M, Higa K, Nitahara K, et al. Optimal depth of insertion of left-sided double lumen endobronchial tubes cannot be predicted from body height in below average-sized adult patients. Eur J Anaesthesiol. 2006;23:42–4.
Brodsky JB, Lemmens HJ. Left double lumen tubes: clinical experience with 1,170 patients. J Cardiothorac Vasc Anesth. 2003;17:289–98.
Redford D, Kim A, Barber B. Transesophageal echocardiography for the intraoperative evaluation of a large anterior mediastinal mass. Anesth Analg. 2006;103:578–9.
Brooker RF, Zvara DA. Mediastinal mass diagnosed with intraoperative transesophageal echocardiography. J Cardiothorac Vasc Anesth. 2007;21:257–8.
Slinger PD, Susssa S, Triolet W. Predicting arterial oxygenation during one-lung anaesthesia. Can J Anaesth. 1992;39:1030–5.
Slinger P, Johnston M. Preoperative evaluation of the thoracic surgery patient. Semin Anesth. 2002;21:168.
Ehrenfeld JM, Mulvoy W, Sandberg WS. Performance comparison of right- and left-sided double-lumen tubes among infrequent users. J Cardiothorac Vasc Anesth. 2010;24:598–601.
Ehrenfeld JM, Walsh JL, Sandberg WS. Right- and left-sided Mallinckrodt double-lumen tubes have identical clinical performance. Anesth Analg. 2008;106:1847–52.
Cohen JA, Denisco RA, Richards TS, et al. Hazardous placement of a Robertshaw-type endobronchial tube. Anesth Analg. 1986;65:100–1.
Brodsky JB, Benumof JL, Ehrenwerth J, et al. Depth of placement of left double-lumen endobronchial tubes. Anesth Analg 1991;73:570–2.
Iwamoto T, Takasugi Y, Hiramatsu K, et al. Three-dimensional CT image analysis of a tracheal bronchus in a patient undergoing cardiac surgery with one-lung ventilation. J Anesth. 2009;23:260–5.
Hagihira S, Takashina M, Mashimo T. Application of a newly designed right-sided, double-lumen endobronchial tube in patients with a very short right mainstem bronchus. Anesthesiology 2008; 109:565–8.
Hansen TB, Watson CB. Tracheobronchial trauma secondary to a Carlens tube. Presented at the Society of Cardiovascular Anesthesiologists 5th annual meeting, San Diego, CA; 1983.
Benumof JL, Partridge BL, Salvatierra C, et al. Margin of safety in positioning modern double-lumen endotracheal tubes. Anesthesiology. 1987;67:729–38.
Brodsky JB, Lemmens HJM. Tracheal width and left double-lumen tube size: a formula to estimate left-bronchial width. J Clin Anesth. 2005;17:267.
Smith GB, Hirsch NP, Ehrenwerth J. Placement of double-lumen endobronchial tubes: correlation between clinical impressions and bronchoscopic findings. Br J Anaesth. 1986;58:1317–20.
McKenna MJ, Wilson RS, Botelho RJ. Right upper lobe obstruction with right-sided double-lumen endobronchial tubes: a comparison of two tube types. J Cardiothorac Anesth. 1988;2:734–40.
Benumof JL, Partridge BL, Salvatierra C, et al. Margin of safety in positioning modern double-lumen endotracheal tubes. Anesthesiology. 1987;67:729.
Thomas V, Neustein SM. Tracheal laceration after the use of an airway exchange catheter for double-lumen tube placement. J Cardiothorac Vasc Anesth. 2007;21:718.
Wagner DL, Gammage GW, Wong ML. Tracheal rupture following the insertion of a disposable double-lumen endotracheal tube. Anesthesiology. 1985;63:698.
Yüceyar L, Kaynak K, Canturk E, et al. Bronchial rupture with a left-sided polyvinylchloride double-lumen tube. Acta Anaesthesiol Scand 2003; 47:622.
Weng W, DeCrosta DJ, Zhang H. Tension pneumothorax during one-lung ventilation: a case report. J Clin Anesth. 2002;14:529.
Zinga E, Dangoisse M, Lechat JP. Tracheal perforation following double-lumen intubation: a case report. Acta Anaesthesiol Belg. 2010;61:71–4.
Read RC, Friday CD, Eason CN. Prospective study of the Robertshaw endobronchial catheter in thoracic surgery. Ann Thorac Surg. 1977;24:156–61.
Dryden GE. Circulatory collapse after pneumonectomy (an unusual complication from the use of a Carlens catheter): case report. Anesth Analg. 1977;56:451–2.
Heike Knoll H, Stephan Ziegeler S, Jan-Uwe Schreiber JU, et al. Airway injuries after one-lung ventilation: a comparison between double-lumen tube and endobronchial blocker: a randomized, prospective, controlled trial. Anesthesiology. 2006;105:471.
Saito S, Dohi S, Tajima K. Failure of double-lumen endobronchial tube placement: congenital tracheal stenosis in an adult. Anesthesiology. 1987;66:83–5.
Inoue H, Shohtsu A, Ogawa J, et al. New device for one-lung anesthesia: endotracheal tube with movable blocker. J Thorac Cardiovasc Surg. 1982;83:940–1.
Murakawa T, Ito N, Fukami T, et al. Application of lobe-selective bronchial blockade against airway bleeding. Asian Cardiovasc Thorac Ann. 2010;18:483–5.
Brodsky JB, Adkins MO, Gaba DM. Bronchial cuff pressures of double-lumen tubes. Anesth Analg. 1989;69:608–10.
Neto PP. Bronchial cuff pressure of endobronchial double-lumen tubes. Anesth Analg 1990; 71:209.
Cohen E. The Cohen Flextip Endobronchial Blocker: an alternative to a double lumen tube. Anesth Analg. 2005;101:1877–9.
Campos JH, Kernstine KH. A comparison of a left-sided Broncho-Cath with the torque control blocker Univent and the wire-guided blocker. Anesth Analg. 2003;96:283–9.
Campos JH. Progress in lung separation. Thorac Surg Clin. 2005;15:71–83.
Narayanaswamy M, McRae K, Slinger P, et al. Choosing a lung isolation device for thoracic surgery: a randomized trial of three bronchial blockers versus double-lumen tubes. Anesth Analg. 2009;108:1097–101.
Ginsberg RJ. New technique for one-lung anesthesia using an endobronchial blocker. J Thorac Cardiovasc Surg. 1981;82:542–6.
Vale R. Selective bronchial blocking in a small child: case report. Br J Anaesth. 1969;41:453–4.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Ranganath, N., Lakshman, K. (2020). Lung Isolation Techniques. In: Sood, J., Sharma, S. (eds) Clinical Thoracic Anesthesia. Springer, Singapore. https://doi.org/10.1007/978-981-15-0746-5_10
Download citation
DOI: https://doi.org/10.1007/978-981-15-0746-5_10
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-0745-8
Online ISBN: 978-981-15-0746-5
eBook Packages: MedicineMedicine (R0)