Clinical experiences of one--lung ventilation in adults using the Univent.

ABSTRACT

OBJECTIVE: To assess the clinical use and intraoperative problems of the Univent tube for one-lung ventilation (OLV). STUDY DESIGN: A cross-sectional descriptive study. MATERIAL AND METHOD: The records of 44 patients undergoing OLV with the Univent tube (Fuji System Corporation, Tokyo) at Chulalongkorn Memorial Hospital, Bangkok, Thailand from 1997 to 2003 were reviewed. The present study data included the techniques of the Univent blocker placement, frequencies of successful OLV being used as an alternative device after failed left-sided double lumen tube (LDLT), and related intraoperative problems during OLV. RESULTS: The blinded rotation method was used for 32 out of 44 cases of the Univent blocker placement, and the success rate of the correct sided placement on the needed bronchus was higher on the right (91.3%) than on the left (66.7%). Therefore, fiberoptic aided technique should be more appropriate for the left-sided blockade. Three successful intubations by the Univent after failed LDLT were found. Two of these had narrow glottic apertures, whereas the other had a stiff neck. Two successful patients after failed bronchial blockades by LDLT according to the anatomical deviation of the carina were demonstrated. However, clinical problems during OLV with the Univent tube were--air trapping, inadequate OLV, herniated bronchial cuff and crossed contamination. CONCLUSION: The Univent tube can be an alternative to LDLT for OLV under the presence of available fiberoptic bronchoscopes, close monitoring and special precautions.