One-lung ventilation in a pediatric patient using a wire-guided endobronchial blocker for video-assisted thoracoscopic surgery: A case report / 대한마취과학회지

Video-assisted thoracoscopic surgery (VATS) has advantages compared with open thoracotomy. One lung ventilation, is indispensible to VATS, commonly is accomplished with a double-lumen endotracheal tube. For infants and small children, there is no double-lumen endotracheal tube suitable, various modified techniques are used to achieve one lung ventilation. Recently introduced a small sized wire-guided endobronchial blocker gives us another choice of one lung ventilation for VATS in small children. Using a wire-guided endobronchial blocker and multiport adapter for young children under flexible bronchoscope, we provided one lung ventilation (OLV) during VATS successfully without complications.

One-lung Ventilation using Wire-guided Endobronchial Blocker and Single Lumen Endotracheal Tube: A Case Report / 대한구급학회지

We had done one-lung ventilation using 9 Fr wire-guided endobronchial blocker and outer diameter 41-mm flexible fiberoptic bronchoscope in ruptured esophageal patient who expected difficult tracheal intubation and in esophageal cancer patient who was in need of mechanical ventilation during and after the operation.

Comparison of the Effects among Three Methods of Bronchial Blockade in One Lung Ventilation / 대한마취과학회지

BACKGROUND: This study compared the modified BronchoCath double-lumen endotracheal tube (DLT) with the Univent bronchial blocker and Arndt's wire-guided endobronchial blocker (WEB) to determine whether there were objective advantages of one over the other during anesthesia with one lung ventilation. METHODS: Forty five patients having either thoracic or esophageal procedures were randomly assigned to one of three groups. Fifteen patients received a left-side DLT, 15 patients received a Univent tube, and 15 patients received a WEB. The following were studied: 1) time required to position each tube until satisfactory placement was achieved, 2) time required until lung collapse, 3) frequency of malpositions after initial placement with fiberoptic bronchoscopy, 4)surgical exposure ranked by surgeons blinded to type of tube used. RESULTS: Statistically significant differences were observed in time required to place the tube or blocker between the WEB (263.6 +/- 76.0 s), DLT (146.4 +/- 57.7 s, I < 0.0001) and Univent tubes (193.8 +/- 72.4 s, P = 0.0130). There were no significant differences in time to lung collapse, the frequency of malposition or surgical exposure. CONCLUSIONS: We conclude that the DLT, Univent tube, and WEB are useful for one lung anesthesia but it takes longer for the WEB to be placed safely than to place a DLT or Univent tube. The selection between the three tubes depends on type of surgery, difficulty of intubation, and familiarity of each tube by the anesthesiologist.