ABSTRACT
The rapid development and promotion of minimally invasive thoracic surgery represented by video-assisted thoracoscopy surgery has gradually replaced traditional thoracic surgery technique as the primary choice for the treatment of pulmonary nodules, including early lung cancer. With the clinical application of double-lumen bronchial catheters, the realization of one-lung ventilation technology not only provides a solid anesthesia foundation for the popularization of minimally invasive thoracic surgery, but also provides a guarantee for the rapid and smooth implementation of the operation. However, compared with single-lumen bronchial catheters, the diameter of the double-lumen bronchial catheter is thicker, and the tube body is hard and difficult to shape, which brings inconvenience to anesthesia intubation. The bronchial structure is different, and the incidence of dislocation during anesthesia intubation is also high. With the gradual clinical use of video double-lumen tube (VDLT), it has become a hot spot in thoracic surgery in recent years. This article reviews the application and research progress of VDLT in thoracic surgery.â©.
Subject(s)
Lung Neoplasms , One-Lung Ventilation , Thoracic Surgery , Humans , Intubation, Intratracheal/methods , Lung Neoplasms/surgery , One-Lung Ventilation/methods , Thoracic Surgery, Video-Assisted/methodsABSTRACT
Intra-operative aerosol-generating procedures are arguably unavoidable in the routine provision of thoracic anaesthesia. Airway management for such patients during the COVID-19 pandemic including tracheal intubation, lung isolation, one-lung ventilation and flexible bronchoscopy may pose a significant risk to healthcare professionals and patients. That said, there remains a need for timely thoracic surgery for patients with lung cancer or thoracic trauma. The thoracic anaesthetic community has been confronted with the need to modify existing techniques to maximise safety for patients and healthcare professionals. With appropriate modification, aerosol generation may be mitigated against in most circumstances. We developed a set of practice-based recommendations for airway management in thoracic surgical patients, which have been endorsed by the Association for Cardiothoracic Anaesthesia and Critical Care and the Society for Cardiothoracic Surgery in Great Britain and Ireland.
Subject(s)
Airway Management/methods , Betacoronavirus , Coronavirus Infections/epidemiology , One-Lung Ventilation/methods , Pneumonia, Viral/epidemiology , Thoracic Surgical Procedures/methods , Airway Extubation , Anesthesia, Cardiac Procedures , Bronchoscopy , COVID-19 , Continuous Positive Airway Pressure , Critical Care , Humans , Intubation, Intratracheal , Pandemics , SARS-CoV-2 , Societies, MedicalSubject(s)
Air Pollutants, Occupational , Betacoronavirus , Coronavirus Infections/prevention & control , Occupational Exposure/prevention & control , One-Lung Ventilation/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Aged , Air Pollutants, Occupational/adverse effects , COVID-19 , Coronavirus Infections/epidemiology , Humans , Male , One-Lung Ventilation/instrumentation , Pneumonia, Viral/epidemiology , SARS-CoV-2ABSTRACT
A novel coronavirus pandemic may be particularly hazardous to health care workers. Airway management is an aerosol-producing high-risk procedure. To minimize the production of airborne droplets, including pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), from the endotracheal tube during procedures requiring lung deflation, we devised a technique to mitigate the risk of infection transmission to health care personnel.