title: Selective lobar bronchial blockade using a double-lumen endotracheal tube and bronchial blocker.
abstract: We report our experience of a selective lobar bronchial blockade (SLBB) technique with a bronchial blocker (BB) which was employed successfully with a routine double-lumen endotracheal tube (DLT) in three patients. For the first case, we selectively blocked the infected left lower lobe in a surgical patient with a lung abscess in a DLT setting. For the second case, we applied this method to block the right middle and lower lobes in order to assess air leakage from the upper lobe during video-assisted thoracic surgery (VATS). For the third case, selective continuous positive airway pressure (CPAP) to the blocked lobes on the operative side resulted in oxygenation improvement with one-lung ventilation (OLV) in a DLT. This novel technique provides benefits during general thoracic surgery by preventing contamination, providing a better operative field, and improving oxygenation with lobar CPAP.
authors.affiliation: Department of Acute Critical Medicine (Anesthesiology), Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sumitani
authors.forename: Yoko
authors.initials: Y
authors.lastname: Matsubara
authors.forename: Takashi
authors.initials: T
authors.lastname: Mashimo
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Takeda
mesh_terms: D000293:Adolescent; D045422:Continuous Positive Airway Pressure; D006801:Humans; D000860:Hypoxia / Q000628:therapy; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008169:Lung Abscess / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D020775:Thoracic Surgery, Video-Assisted