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Muelleck JR, Maracaja L, Templeton TW. Selective Lobar Blockade With a Bronchial Blocker in Combination With a Double Lumen Tube to Manage Refractory Hypoxemia: A Case Report. Cureus 2022; 14:e26638. [PMID: 35949780 PMCID: PMC9356596 DOI: 10.7759/cureus.26638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/05/2022] Open
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Cruz P, Orozco HD, Garutti Martinez I, Hernández Fernández G. Bloqueio lobar seletivo com um bloqueador Coopdech combinado com um tubo endotraqueal de duplo lúmen para ressecção de metástases pulmonares com laser. Braz J Anesthesiol 2018; 68:200-204. [DOI: 10.1016/j.bjan.2017.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/15/2016] [Indexed: 10/19/2022] Open
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Honikman R, Rodriguez-Diaz CA, Cohen E. A Ballooning Crisis: Three Cases of Bronchial Blocker Malfunction and A Review. J Cardiothorac Vasc Anesth 2017; 31:1799-1804. [PMID: 28476448 DOI: 10.1053/j.jvca.2017.02.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Rafael Honikman
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
| | | | - Edmond Cohen
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY
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Omori C, Toyama H, Takei Y, Ejima Y, Yamauchi M. Positive pressure ventilation in a patient with a right upper lobar bronchocutaneous fistula: right upper bronchus occlusion using the cuff of a left-sided double lumen endobronchial tube. J Anesth 2017; 31:627-630. [PMID: 28315041 DOI: 10.1007/s00540-017-2336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/13/2017] [Indexed: 11/24/2022]
Abstract
In patients with a bronchocutaneous fistula, positive pressure ventilation leads to air leakage and potential hypoxemia. A male patient with a right upper bronchocutaneous fistula was scheduled for esophageal reconstruction. His preoperative chest computed tomography image revealed aeration in the right middle and lower lobe, a large bulla in the left upper lobe, and pleural effusion and pneumonia in the left lower lobe. Therefore, left one-lung ventilation was considered to result in hypoxemia. Before anesthesia induction, the bronchocutaneous fistula was covered with gauze and film to prevent air leakage. After anesthesia induction, mask ventilation was performed with a peak positive pressure of 10 cmH2O. A left-sided double lumen endobronchial tube (DLT) was then inserted into the right main bronchus for occluding only the right superior bronchus, and two-lung ventilation was performed to minimize airway pressure and maintain oxygenation, which did not cause air leakage through the fistula. During anesthesia, no ventilation-related difficulty was faced. The method of inserting a left-sided DLT into the right main bronchus and occluding the right upper bronchus selectively by bronchial cuff is considered to be an option for mechanical ventilation in patients with a right upper bronchial fistula, as demonstrated in the present case.
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Affiliation(s)
- Chieko Omori
- Department of Anesthesiology, Tohoku University Hospital, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan.
| | - Hiroaki Toyama
- Department of Anesthesiology, Tohoku University Hospital, 1-1 Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yusuke Takei
- Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yutaka Ejima
- Division of Surgical Center and Supply, Sterilization, Tohoku University Hospital, Sendai, Japan
| | - Masanori Yamauchi
- Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Kamra SK, Jaiswal AA, Garg AK, Mohanty MK. Rigid Bronchoscopic Placement of Fogarty Catheter as a Bronchial Blocker for One Lung Isolation and Ventilation in Infants and Children Undergoing Thoracic Surgery: A Single Institution Experience of 27 Cases. Indian J Otolaryngol Head Neck Surg 2016; 69:159-171. [PMID: 28607884 DOI: 10.1007/s12070-016-1026-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 10/05/2016] [Indexed: 11/30/2022] Open
Abstract
One-lung ventilation (OLV) is a challenging task in infants and children as few techniques are possible because of narrow anatomy. The aim of this study is to evaluate and experience lung isolation with Fogarty catheters as a bronchial blocker placed by rigid bronchoscope for OLV in infants and children with lung pathologies requiring surgical management in an industrial hospital. This study is a prospective study carried out in J.L.N. Hospital and Research Centre, Bhilai (CG), from January 2011 to December 2014. The study was designed to place Fogarty catheter for achieving OLV using rigid bronchoscope in children. The patient and anaesthesia characteristics, placement and positioning of Fogarty catheters, intraoperative course, complications and recovery of the patient were studied. The data were then compared with the relevant and available literature. Over the study period of 4 years, 27 cases were included, out of which 22 (81.48 %) cases had suppurative lung disease, three cases (11.11 %) had hydatid cyst of the lung, whereas one case (3.7 %) each of congenital lobar emphysema and congenital cystic adenomatoid malformation of the lung, respectively. In all cases general anaesthesia was provided using single lumen endotracheal tube and one lung ventilation achieved by parallel placement of Fogarty catheter as a bronchial blocker with rigid bronchoscope. The surgical management included thoracotomy with decortication in 21 cases, thoracotomy with excision of hydatid cyst in 3 cases, video-assisted thoracoscopic surgery, thoracotomy with left upper lobectomy and thoracotomy with left lower lobectomy in one case each, respectively. There were no major intraoperative and postoperative complications. There was no mortality in our study. We conclude that rigid bronchoscope can be safely and effectively used to place Fogarty catheter in main bronchus in infants and children for achieving OLV.
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Affiliation(s)
- Sunil Kant Kamra
- Department of Anaesthesia, J.L.N. Hospital and Research Centre, Bhilai, CG India
| | - Ashwin Ashok Jaiswal
- Department of ENT and Head Neck Surgery, J.L.N. Hospital and Research Centre, Sector 9, Bhilai, Dist. Durg, CG 490009 India
| | - Amrish Kumar Garg
- Department of ENT and Head Neck Surgery, J.L.N. Hospital and Research Centre, Sector 9, Bhilai, Dist. Durg, CG 490009 India
| | - Manoj Kumar Mohanty
- Department of Paediatric Surgery, J.L.N. Hospital and Research Centre, Bhilai, CG India
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Murakawa T, Ito N, Fukami T, Nakajima J, Takamoto S. Application of lobe-selective bronchial blockade against airway bleeding. Asian Cardiovasc Thorac Ann 2010; 18:483-5. [PMID: 20947606 DOI: 10.1177/0218492310380279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 48-year-old man underwent resection of a right upper lobe necrotic tumor and part of his chest wall. Lobe-selective bronchial blockade of bleeding from the right upper lobe was achieved by combining a left-side double-lumen endotracheal tube with a bronchial blocker placed at the right intermediate bronchus. The bleeding right upper lobe was isolated, and the other lobes were protected from blood contamination during the lobectomy procedure.
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Affiliation(s)
- Tomohiro Murakawa
- Department of Cardiothoracic Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
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Sumitani M, Matsubara Y, Mashimo T, Takeda SI. Selective lobar bronchial blockade using a double-lumen endotracheal tube and bronchial blocker. Gen Thorac Cardiovasc Surg 2007; 55:225-7. [PMID: 17555000 DOI: 10.1007/s11748-007-0108-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report our experience of a selective lobar bronchial blockade (SLBB) technique with a bronchial blocker (BB) which was employed successfully with a routine double-lumen endotracheal tube (DLT) in three patients. For the first case, we selectively blocked the infected left lower lobe in a surgical patient with a lung abscess in a DLT setting. For the second case, we applied this method to block the right middle and lower lobes in order to assess air leakage from the upper lobe during video-assisted thoracic surgery (VATS). For the third case, selective continuous positive airway pressure (CPAP) to the blocked lobes on the operative side resulted in oxygenation improvement with one-lung ventilation (OLV) in a DLT. This novel technique provides benefits during general thoracic surgery by preventing contamination, providing a better operative field, and improving oxygenation with lobar CPAP.
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Affiliation(s)
- Masahiko Sumitani
- Department of Acute Critical Medicine (Anesthesiology), Osaka University Graduate School of Medicine, Osaka, Japan
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Glümer Jensen M, Knudsen L, Schønemann NK. Treatment of a transdiaphragmatic fistula with an endobronchial-blocking catheter. Acta Anaesthesiol Scand 2004; 48:1338-40. [PMID: 15504198 DOI: 10.1111/j.1399-6576.2004.00499.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report a case of a bronchosubphrenic fistula in a 59-year-old female following hemicolectomy complicated by fecal peritonitis. The patient needed intubation and positive-pressure ventilation, which caused a massive air leak. The fistula was treated using an endobronchial blocking catheter in combination with antibiotic treatment and drainage.
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Affiliation(s)
- M Glümer Jensen
- Department of Anesthesiology and Intensive Care, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark.
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Abstract
Techniques for one-lung ventilation (OLV) can be accomplished in two ways: The first involves the use of a double-lumen endotracheal tube (DLT). The second involves blockade of a mainstem bronchus (bronchial blockers). Bronchial blockade technology is on the rise, and in some specific clinical situations (e.g., management of the difficult airway during OLV or selective lobar blockade) it can offer more as an alternative to achieve OLV in adults. Special emphasis on newer information for the use of Fogarty embolectomy catheter as a bronchial blocker, the torque control blocker Univent, and the wire-guided endobronchial blocker (Arndt blocker) is included. Also this review describes placement, positioning, complications, ventilation modalities, and airflow resistances of all three bronchial blockers. Finally, the bronchial blockers can be used in many cases that require OLV, taking into consideration that bronchial blockers require longer time for placement, assisted suction to expedite lung collapse, and the use of fiberoptic bronchoscopy. The current use of bronchial blockers, supported by scientific evidence, dictates that bronchial blockers should be available in any service that performs lung separation techniques.
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Affiliation(s)
- Javier H Campos
- Department of Anesthesia, University of Iowa Health Care, Iowa City, Iowa
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Reinoso-Barbero F, Sanabria P, Bueno J, Suso B. High-Frequency Ventilation for a Child with Traumatic Bronchial Rupture. Anesth Analg 1995. [DOI: 10.1213/00000539-199507000-00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Reinoso-Barbero F, Sanabría P, Bueno J, Suso B. High-frequency ventilation for a child with traumatic bronchial rupture. Anesth Analg 1995; 81:183-5. [PMID: 7598254 DOI: 10.1097/00000539-199507000-00038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- F Reinoso-Barbero
- Departamento de Anestesiología, Facultad de Medicina, Universidad Autónoma de Madrid, Hospital Infantil La Paz, Spain
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