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fibreoptic double lumen

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
P T Chen, C K Ting, M Y Lee, H W Cheng, K H Chan, W K Chang
Double-lumen endobronchial tube placement is challenging. This study compared double-lumen tube placement with the Disposcope(®) , a wireless videostylet allowing real-time visualisation, with conventional blind placement. Patients undergoing elective thoracic surgery with normal airways requiring one-lung ventilation were randomly allocated into two groups (27 patients in each group). The Disposcope was used to assist left-sided double-lumen tube placement in one group, and conventional blind placement was performed in the control group...
September 2017: Anaesthesia
I L Rapchuk, Sam Kunju, I J Smith, D J Faulke
For a six-month period, all airway options used for non-emergent patients undergoing thoracic surgery requiring one-lung ventilation at a single institution were assessed after introduction of the VivaSight™ double-lumen endotracheal tube (VivaSight-DL), a novel double-lumen tube with an integrated camera. This device displays a continuous view of the position of the tube relative to the carina. A total of 72 patients had lung separation with the VivaSight-DL. Lung separation was achieved on first attempt without additional manipulation in 85% of cases...
March 2017: Anaesthesia and Intensive Care
Vandana Pandey, Dharam S Meena, Swati Choraria, Sushil Guria
Tracheobronchial injuries are rare cases requiring skillful airway management. We report a challenging case of tracheobronchial injury in a young adult who was run over by a tractor and was referred to us from a peripheral hospital with endotracheal tube in situ. He was severely hypoxaemic on initial presentation. Diagnostic work up showed high suspicion for right bronchial transection along with left lung upper lobe contusion. Due to deteriorating clinical condition of the patient and despite immediate unavailability of fibreoptic bronchoscope, patient was immediately taken up for right posterolateral thoracotomy and double lumen tube was inserted...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
D Levy-Faber, Y Malyanker, R-R Nir, L A Best, M Barak
The efficiency of a double-lumen tube depends on its position in the airways, which can be verified by fibreoptic bronchoscopy. The VivaSight DL is a single-use double-lumen tube with a camera embedded in the tube's right side. The view from the camera appears continuously on a monitor. In this prospective study of 71 adult patients, we compared intubation times using either the VivaSight DL or a conventional double-lumen tube. Median (IQR [range]) duration of intubation with visual confirmation of tube position was significantly reduced using the VivaSight DL compared with the conventional double-lumen tube (51 (42-60 [35-118]) s vs 264 (233-325 [160-490]) s, respectively, p < 0...
November 2015: Anaesthesia
E M Koopman, M Barak, E Weber, M J A Valk, R T I de Schepper, R A Bouwman, J M Huitink
The VivaSight-DL(™) is a new single-use double-lumen endobronchial tube with an integrated camera. We studied this device in 151 consecutive patients scheduled for elective thoracic surgery in four different hospitals. Endobronchial intubation was successful in 148 patients (98%) (95% CI 94-99%). Median (IQR [range]) endobronchial intubation time was 59 (47-82 [17-932]) s and lung isolation was successfully achieved in 147 (99%) patients (95% CI 96-99%). A fibreoptic bronchoscope was required to assist endobronchial tube placement in 19 (13%) patients (95% CI 8-19%)...
August 2015: Anaesthesia
Mohamed R El-Tahan
BACKGROUND: The use of the Arndt endobronchial blocker has not gained widespread acceptance during video-assisted thoracoscopic surgery (VATS) because of its high cost and longer time to operative lung collapse especially in patients with chronic obstructive pulmonary disease (COPD). The use of a ventilator disconnection technique has been shown to produce a comparable degree of lung collapse when used with either a double-lumen tube or an Arndt endobronchial blocker. OBJECTIVE: We hypothesised that the use of bronchial suction through the suction port of the endobronchial blocker would be associated with a comparable time to achieve optimum lung collapse as the disconnection technique...
June 2015: European Journal of Anaesthesiology
Young-Jin Moon, Sung-Hoon Kim, Sang Wook Park, Yu Mi Lee
PURPOSE: Due to its anatomical complexity, a tracheal bronchus has important clinical implications for one-lung ventilation (OLV). We present a case of successful OLV in a patient with a high a type I (i.e., high take-off) tracheal bronchus. This anomaly presented unusual fibreoptic bronchoscopic (FOB) views that were difficult to discern from the normal carinal bifurcation. CLINICAL FEATURES: A 35-yr-old male presented for posterior basal segmentectomy of the left lower lobe under video-assisted thoracoscopy...
April 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Alparslan Kus, Cigdem N Gok, Tulay Hosten, Yavuz Gurkan, Mine Solak, Kamil Toker
BACKGROUND: Supraglottic airway devices such as the LMA-Supreme (LMA-S) and I-gel, which have an additional lumen for the insertion of a gastric tube, can be useful in the management of the difficult airway. OBJECTIVE: To test the performance of these two devices in the difficult paediatric airway. DESIGN: Randomised double-blind study. SETTING: Anaesthesia department, university hospital. PATIENTS: Sixty American Society of Anesthesiologists (ASA) I-II children undergoing elective surgery...
May 2014: European Journal of Anaesthesiology
Shin H Kim, Yong S Choi, Seokyung Shin, Jin S Cho, Da J Nam, Young J Oh
BACKGROUND: Peak inspiratory pressures (PIPs) during one-lung ventilation (OLV) have served as a clinical marker that could indirectly verify the proper positioning of double-lumen tubes (DLTs). Patients of short stature are highly susceptible to initial DLT malpositioning. OBJECTIVES: We investigated the usefulness of positioning left-sided DLTs using minimum PIP differences between the right and left lungs by comparing with the previously used method of auscultation without fibreoptic bronchoscopy (FOB)...
March 2014: European Journal of Anaesthesiology
J H Campos, E A Hallam, K Ueda
BACKGROUND: Obese patients are at risk of complications during airway management including difficult tracheal intubation. There are no reports regarding the ease of intubation or efficiency of lung collapse with the use of lung isolation devices for the morbidly obese patient. We conducted a prospective, randomized study in morbidly obese patients undergoing one-lung ventilation. We compared the effectiveness and ease of placement of a left-sided double-lumen tube and the Arndt(®) blocker...
October 2012: British Journal of Anaesthesia
Xiao-qin Zheng, Zhi-hong Zheng, Ming-wei Shang, Jian-cheng Zhu
OBJECTIVE: To explore the effect of children-sized fibreoptic bronchoscope in improving the safety of whole-lung lavage (WLL). METHOD: Patients from May 2006 to May 2010 using children-sized fibreoptic bronchoscope to assistant the location were assigned to fibreoptic bronchoscope group. Patients from May 1998 to Nov 2004 using traditional stethoscope to help intubation were assigned to control group. The adverse reactions and complications were compared. RESULT: There were liquid leakage 1 case (0...
October 2011: Chinese Journal of Industrial Hygiene and Occupational Diseases
K Ruetzler, G Grubhofer, W Schmid, D Papp, S Nabecker, D Hutschala, G Lang, H Hager
BACKGROUND: In several clinical situations, lung separation and single-lung ventilation (SLV) is essential. In these cases, the double-lumen tube (DLT) is the most widely used device. Bronchial blocker such as Univent or Arndt Blocker serves as an alternative. The EZ-Blocker(®) (EZ; AnaesthetIQ B.V., Rotterdam, The Netherlands) is a new device promising to exceed clinical performance of DLT. The aim of this study was to assess the clinical performance of EZ in comparison with conventional left-sided DLT...
June 2011: British Journal of Anaesthesia
Toru Iizuka, Naohito Shimoyama, Luigi Fuggiano, Atsuko Notoya
BACKGROUND: One-lung ventilation and lung isolation are frequently required in thoracic surgery. In clinical practice, lung isolation is achieved by use of a double-lumen endotracheal tube and a bronchial blocker. A novel bagel shaped bronchial blocker, the Fuggiano's bronchial blocker, has been designed to prevent displacement of the blocker from its position in the bronchus. In this study, we evaluated the clinical performance of the Fuggiano's bronchial blocker for the lung isolation...
December 2010: Masui. the Japanese Journal of Anesthesiology
R C Clarke, A I Gardner
The purpose of this study was to estimate the exposure of trainees to airway management techniques in an Australian tertiary adult teaching hospital. Anaesthesia records for all patients over a 20-week period were reviewed and the following data were obtained: the presence of a trainee, the type of airway used, the grade of the laryngoscopic view and the use of non-standard laryngoscopy for intubation. Data was recorded contemporaneously and analysed retrospectively. The data was then extrapolated to give a yearly estimate of airway procedures per trainee...
July 2008: Anaesthesia and Intensive Care
D Steinmann, C A Stahl, J Minner, S Schumann, T Loop, A Kirschbaum, H J Priebe, J Guttmann
BACKGROUND: Double-lumen tubes (DLTs) are frequently used to establish one-lung ventilation (OLV). Their correct placement is crucial. We hypothesized that electrical impedance tomography (EIT) reliably displays distribution of ventilation between left and right lung and may thus be used to verify correct DLT placement online. METHODS: Regional ventilation was studied by EIT in 40 patients requiring insertion of left-sided DLTs for OLV during thoracic surgery. EIT was recorded during two-lung ventilation before induction of anaesthesia and after DLT placement, and during OLV in the supine and subsequently in the lateral position...
September 2008: British Journal of Anaesthesia
S Ghosh, A A Klein, M Prabhu, F Falter, J E Arrowsmith
BACKGROUND: A novel double-lumen endotracheal tube, the Papworth BiVent tube, has been designed to allow the rapid passage of a blocker into either main bronchus, without fibreoptic endoscopic guidance. METHODS: The feasibility of lung isolation and one-lung ventilation (OLV) in human cadavers is examined, along with displacement of the bronchus blocker during head and neck movement. RESULTS: Cadaveric endotracheal intubation with the Papworth BiVent tube was straightforward and comparable with intubation with a conventional single-lumen tube (SLT)...
September 2008: British Journal of Anaesthesia
S Ghosh, F Falter, K Goldsmith, J E Arrowsmith
Provision of one lung ventilation can be technically challenging, particularly for anaesthetists who are only occasionally required to isolate one lung from the other. A new double lumen endotracheal tube, the Papworth BiVent Tube, has been designed to enable rapid and reliable lung isolation using any bronchus blocker without the need for fibreoptic endoscopic guidance. In this study, an airway-training manikin was used to assess ease of tracheal intubation and lung isolation using the Papworth BiVent tube...
September 2008: Anaesthesia
Jean S Bussières, Yves Lacasse, Dany Côté, Michel Beauvais, Sophie St-Onge, Jérôme Lemieux, Julie Soucy
OBJECTIVE: A left-sided double lumen tube is recommended for one-lung ventilation for most thoracic surgeries, but for certain indications, a right-sided double lumen tube (R-DLT) may be mandatory. Frequent malposition of R-DLTs has been reported. We propose an innovative modification of Mallinckrodt's Broncho-Cath R-DLT consisting of an enlarged area of the lateral orifice, and studied the impact of this modification on the adequacy of R-DLT positioning. METHODS: Eighty adult patients scheduled for elective thoracic surgery were randomized into two groups: standard Broncho-Cath R-DLT, or modified Broncho-Cath R-DLT...
April 2007: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
I D Conacher, H Velasquez, D J Morrice
An endobronchial tube (Macintosh-Leatherdale) was used to secure the airway for a tracheal resection and end-to-end anastomosis. This lung separation device enabled insertion of both a fibreoptic bronchoscope and a tube exchange catheter. These were required after the trachea was transected and re-anastomosis proved surgically difficult. The airway exchange catheter allowed for jet ventilation and later a tube change when an emergency occurred. Options and management issues for tracheal surgery and lung separators are discussed...
June 2006: Anaesthesia
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