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double lumen tube

Christopher Ull, Mirko Aach, Josef Reichert, Thomas Armin Schildhauer, Justyna Swol
Pulmonary infections are life-threatening complications in patients with spinal cord injuries. In particular, paraplegic patients are at risk if they are ventilator-dependent. This case history refers to a spinal cord injury with a complete sensorimotor tetraplegia below C2 caused by a septic scattering of an intraspinal empyema at C2-C5 and T3-T4. A right-sided purulent pneumonia led to a complex lung infection with the formation of a pleuroparenchymal fistula. The manuscript describes successful, considerate, non-surgical management with shortterm separate lung ventilation...
January 29, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Tom Kreft, Thomas Hachenberg
Traditionally the double-lumen-tube (DLT) is considered the gold standard for lung separation. Despite being equally feasible for standard situations, there are special populations and circumstances requiring the use of a bronchial blocker (BB) to establish one-lung ventilation. Children under 8 years of age and patients without a patent orotracheal airway necessitate the use of a bronchial blocker in most cases, as well as those requiring selective lobar blockade or a rapid sequence induction. Surgery with predicted postoperative mechanical ventilation or in tracheotomized patients at least favors their use by avoiding the complications of a tube exchange...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Torsten Loop, Johannes Spaeth
Lung separation and isolation with accomplished one-lung ventilation plays a key role in the airway management for thoracic surgery. Spectrum of indication contains thoracic surgery, procedure- and patient-dependent factors. Usually lung isolation is achieved with a double-lumen tube or a bronchial blocker. Knowledge in tracheobronchial anatomy is routinely requested for anesthesiologists just as the standard use of flexible fibreoptic bronchoscope. This review would give an overview and discussion about the airway management in patients during thoracic anesthesia with double-lumen tubes and recommendations for the clinical routine...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Ji Young Yoo, Sung Yong Park, Jong Yeop Kim, Myungseob Kim, Seok Jin Haam, Dae Hee Kim
BACKGROUND: Double lumen endobronchial tube (DLT) intubation is commonly used for one-lung ventilation in thoracic surgery. However, because of its large size and shape, it is difficult to perform intubation compared with a single lumen tube. The aim of this randomized controlled trial was to determine whether the McGrath videolaryngoscope has any advantage over the direct Macintosh laryngoscope for DLT intubation in patients with a simulated difficult airway. METHODS: Forty-four patients (19-60 years of age); scheduled to undergo general anesthesia with one-lung ventilation were assigned to 1 of 2 groups: DLT intubation with the McGrath videolaryngoscope (ML group [n = 22]); or conventional Macintosh laryngoscope (DL group [n = 22])...
March 2018: Medicine (Baltimore)
Zheng Yao, Weiliang Tian, Xin Xu, Qian Huang, Yunzhao Zhao
RATIONALE: Currently, the use of double-lumen irrigation-suction tube for drainage has become increasingly more common. However, the insertion process is complex, and the position of the double cannula placed in this manner is not accurate. We developed a method for placing the drainage tube and use it in the treatment of an abdominal infection. PATIENT CONCERNS: A 51-year-old man with an abdominal infection due to colonic anastomotic fistula was admitted. Routine laboratory tests revealed an elevated white blood cell count (17 × 10/L) and C-reactive protein level (78 mg/L)...
March 2018: Medicine (Baltimore)
Tong Qiu, Baohua Yu, Yunpeng Xuan, Haihong Luan, Wenjie Jiao
We describe a novel method using electromagnetic navigation bronchoscopy (ENB) without dye marking to perform vectorial localization for an impalpable peripheral lesion in the right lower lobe during diagnostic surgical resection in a 52-year-old woman. After the ENB registration process, the anesthetist changed the single-lumen endotracheal tube to a double-lumen endobronchial tube. Guided by the ENB system, the operator delivered the probe of the locatable guide to the planned site through the right lumen of the endobronchial tube...
February 23, 2018: Thoracic Cancer
Benedetta Bedetti, Davide Patrini, Luca Bertolaccini, Roberto Crisci, Piergiorgio Solli, Joachim Schmidt, Marco Scarci
Uniportal video-assisted thoracoscopic surgery (VATS) is the most advanced evolution of the minimally invasive technique, which allows often the possibility to include patients in enhanced recovery programs in order to optimize the therapeutic pathway, shorten the length of stay and reduce hospital costs. Non-intubated VATS procedures allow the performance of surgeries with minimal sedation without general anesthesia, maintaining throughout the operation spontaneous breathing. The principle is to create an iatrogenic spontaneous pneumothorax, which can provide a good lung isolation without the need of a double lumen tube...
2018: Journal of Visualized Surgery
Zhanqi Zhao, Wei Wang, Zuojing Zhang, Meiying Xu, Inez Frerichs, Jing-Xiang Wu, Knut Moeller
The aim of the study was to explore the feasibility of titrating tidal volume (VT) and positive end-expiratory pressure (PEEP) during one-lung ventilation (OLV) based on ventilation distribution and oxygenation. Approach: Twenty four consecutive patients requiring intubation with a double-lumen tube and subsequent OLV for thoracic surgical procedures were examined prospectively in lateral posture. Electrical impedance tomography (EIT), blood gases, respiratory mechanics were successfully measured in 21 patients at various combinations of VT (4 ml/kg, 6 ml/kg, 8 ml/kg body weight) and PEEP (0 cmH2O, 4 cmH2O, 8 cmH2O) during OLV...
February 12, 2018: Physiological Measurement
Waseem M Hajjar, Sami A Al-Nassar, Ghaida S Al-Sugair, Alaa Al-Oqail, Shahd Al-Mansour, Rand Al-Haweel, Adnan W Hajjar
Background: Interstitial lung diseases are diseases that need histology diagnosis or obtaining a lung biopsy to establish the diagnosis. Surgical biopsies are performed usually using the thoracoscopy technique under general anesthesia (GA) although this procedure is still associated with morbidity rate. The aim of this study is to determine the effectiveness and safety of regional anesthesia (RA) compared with GA in thoracoscopic lung biopsy procedures done on patients with idiopathic pulmonary fibrosis (IPF)...
January 2018: Saudi Journal of Anaesthesia
T T Liu, L Li, L Wan, C H Zhang, W L Yao
Double-lumen intubation is more difficult than single-lumen tracheal intubation. Videolaryngoscopes have many advantages in airway management. However, the advantages of videolaryngoscopy for intubation with a double-lumen tube remain controversial compared with traditional Macintosh laryngoscopy. In this study, we searched MEDLINE, Embase, Cochrane Library and the Web of Science for randomised controlled trials comparing videolaryngoscopy with Macintosh laryngoscopy for double-lumen tube intubation. We found that videolaryngoscopy provided a higher success rate at first attempt for double-lumen tube intubation, with an odds ratio (95%CI) of 2...
February 6, 2018: Anaesthesia
Daniel Laroche, Chester Ng, Giselle Lynch
PURPOSE: To describe a new surgical technique for refractory glaucoma with failed XEN gel stent surgery with insertion of the Baerveldt implant. SURGICAL TECHNIQUE: In a patient with a failed XEN gel stent, a gentle conjunctival dissection was performed to expose the XEN and remove subconjunctival obstruction thus restoring patency and flow. A Baerveldt 250 implant was inserted in the superonasal quadrant above the extraocular muscles and sutured to the sclera. The Baerveldt tube was correctly positioned to accept insertion of the present XEN gel stent...
February 1, 2018: Journal of Glaucoma
Xian Zhao, Yuhong Li, Hai-Ying Kong, Lin Zhang, Xiao-Hong Wen
RATIONALE: Survey data show approximately 10% patients with lung cancer may present concomitant coronary heart disease. Simultaneous surgery is a challenge for anesthetist. We review our experience in the anesthesia with 5 patients who required simultaneous off-pump coronary artery bypass grafting (OPCABG) and pulmonary resection for lung cancer. PATIENT CONCERNS: Between 2014 and 2016, 5 patients with ASA (American Society of Anesthesiologists) grade II or III, underwent combined OPCABG and lung resection in the first Affiliated Hospital, Zhejiang University School of Medicine...
December 2017: Medicine (Baltimore)
Liu Shiqing, Qi Wenxu, Zhang Jin, Dong Youjing
OBJECTIVES: The aims of this study were to measure diameters of the cricoid ring and left main bronchus in Asian adult patients and to assess the accuracy of double lumen tube size selected according to cricoid and left main bronchus diameter, respectively. DESIGN: Retrospective observational study. SETTING: Academic, tertiary care hospital. PARTICIPANTS: Preoperative CT scans from 87 men and 94 women who had undergone general anesthesia for lung operations...
November 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Kong Eric You-Ten, Naveed Siddiqui, Wendy H Teoh, Michael S Kristensen
Airway management is a critical skill in the practice of several medical specialities including anesthesia, emergency medicine, and critical care. Over the years mounting evidence has showed an increasing role of ultrasound (US) in airway management. The objective of this narrative review is to provide an overview of the indications for point-of-care ultrasound (POCUS) of the upper airway. The use of US to guide and assist clinical airway management has potential benefits for both provider and patient. Ultrasound can be utilized to determine airway size and predict the appropriate diameter of single-lumen endotracheal tubes (ETTs), double-lumen ETTs, and tracheostomy tubes...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
Michael Essandoh, Michael Andritsos
No abstract text is available yet for this article.
November 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Xiang Quan, Jie Yi, Yuguang Huang, Xiuhua Zhang, Le Shen, Shanqing Li
Background: Bronchial suction through the lumen of a bronchial blocker has been reported to accelerate lung collapse. The aim of the current study was to examine whether bronchial suction could also facilitate lung collapse when using a double-lumen tube (DLT). Methods: Eighty patients scheduled for elective video-assisted thoracoscopic surgery for lung cancer using a DLT for one-lung ventilation (OLV) were randomised into an arm that received bronchial suction and an arm that underwent spontaneous collapse (n=40 per arm)...
December 2017: Journal of Thoracic Disease
Seung Hwan Seol, Woon Jeong Lee, Seon Hee Woo, Dae Hui Kim, Jong Hui Suh
Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may cause airway obstruction and resulting life-threatening respiratory deficiency. However, the clinical presentations are variable and frequently difficult to diagnose. We report a case of a previously healthy 16-year-old man with complete right main bronchial transection sustained after a vehicular accident, who had progressive dyspnea, subcutaneous emphysema in the neck and anterior chest wall, and bilateral tension pneumothorax...
December 2017: Clinical and Experimental Emergency Medicine
Shi Yang Li, Wei Yu Yao, Yong Jin Yuan, Wen Shu Tay, Nian-Lin Reena Han, Rehena Sultana, Pryseley N Assam, Alex Tiong-Heng Sia, Ban Leong Sng
BACKGROUND: The Supreme™ laryngeal mask airway (SLMA) is a single-use LMA with double lumen design that allows separation of the respiratory and the alimentary tract, hence potentially reducing the gastric volume and risk of aspiration. The purpose of this prospective cohort study is to evaluate the the role of the SLMA as an airway technique for women undergoing category 2 and 3 Cesarean delivery under general anesthesia. METHODS: We recruited 584 parturients who underwent category 2 or 3 Cesarean delivery under general anesthesia, in which 193 parturients underwent category 2 and 391 parturients underwent category 3 Cesarean delivery...
December 19, 2017: BMC Anesthesiology
Yao Lu, Wei Dai, Zhijun Zong, Yimin Xiao, Di Wu, Xuesheng Liu, Gordon Tin Chun Wong
OBJECTIVE: The aim of this study was to compare the quality of lung deflation of a left-sided double-lumen endotracheal tube (DLT) with a bronchial blocker (BB) for one-lung ventilation in video-assisted thoracic surgery (VATS). DESIGN: A prospective, randomized, clinical study. SETTING: A university-affiliated teaching hospital. PARTICIPANTS: Forty-five adult patients undergoing esophageal tumor surgery using VATS with right lung deflation...
July 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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