Endobronchial tubes - a case for re-evaluation.
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. A case is made for a re-evaluation of endobronchial tubes both as a useful conduit for modern airway instruments and as an alternative to small double-lumen tubes for the increasing population of obese patients weighing > 100 kg, requiring thoracic surgery.
Conacher
I D
ID
Cardiothoracic Anaesthesia Department, Freeman Hospital, Newcastle Hospitals NHS Trust, Newcastle upon Tyne, England, UK. i.d.conacher@binternet.com
Velasquez
H
H
Morrice
D J
DJ
D000368:Aged; D000714:Anastomosis, Surgical; D000768:Anesthesia, General / Q000379:methods; D001980:Bronchi; D001999:Bronchoscopy; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology; D006611:High-Frequency Jet Ventilation / Q000379:methods; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D014134:Tracheal Neoplasms / Q000601:surgery*