Successful left-sided one-lung ventilation using two Arndt endobronchial blockers in a patient with right tracheal bronchus

Successful left-sided one-lung ventilation using two Arndt endobronchial blockers in a patient with right tracheal bronchus

Published: 26 Jun 2018

© Anaesthesia Cases / 2018-0095 / ISSN 2396-8397

Authors

Dr Heejoon Jeong [1]
Dr Burn Young Heo [2]
Dr Soo Jung Park [3]
Dr Ah Ran Oh [3]
  • [1] Anaesthetic Fellow, Department of Anaesthesiology and Pain medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea (Republic Of)
  • [2] Professor, Department of Anaesthesiology and Pain medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea (Republic Of)
  • [3] Medical Doctor, Department of Anaesthesiology and Pain medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea (Republic Of)

Summary

One-lung ventilation is frequently performed during operations that require a transthoracic approach. Although a double-lumen tube is the most common device used for definitive lung isolation, if a patient has a tracheobronchial anomaly, such as tracheal bronchus, or if an anaesthetist cannot apply the double-lumen tube due to specific surgical manipulation requirements, a bronchial blocker can be an alternative. In some cases where lung isolation cannot be achieved by using a DLT or one bronchial blocker, the use of dual bronchial blockers can be a feasible option. We present the case of successful left-sided one-lung ventilation using two Arndt bronchial blockers in a patient with a right upper lobe tracheal bronchus who underwent robotic oesophagectomy. We conducted a bi-luminal (intraluminal and extraluminal) insertion technique for both precise placement of the blockers and also enabling adequate ventilation. Dual blockers with bi-luminal insertion can be an alternative in complicated cases.

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