Application of a double-lumen tube for one-lung ventilation in patients with anticipated difficult airway.
One-lung ventilation (OLV) is essential in some surgical situations. The use of double- lumen tubes (DLTs) can achieve OLV more quickly and more easily than bronchial blockers. The management of a difficult airway is a challenge for anesthesiologists when, at the same time, OLV is needed for a surgical procedure. This report describes the successful application of DLTs in two patients with difficult airways, and who were scheduled for pulmonary decortication. Case 1 already had a permanent tracheostomy, while Case 2 had oral cancer with an extremely limited mouth opening and needed elective tracheostomy for anesthesia. Nasal intubation of Case 2 was done with fiberoptic-guided intubation with the patient awake. OLV was achieved uneventfully after inserting the DLT directly through the tracheostomy in both cases. We also describe the appropriate use of airway devices for OLV, focusing on patients with an anticipated difficult airway.
Shih
Chih-Kai
CK
Department of Anesthesiology, Kaohsiung Medical University Hospital, and Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C.
Kuo
Yi-Wei
YW
Lu
I-Chen
IC
Hsu
Hong-Te
HT
Chu
Koung-Shing
KS
Wang
Fu-Yuan
FY
D000328:Adult; D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D009062:Mouth Neoplasms / Q000601:surgery; D012121:Respiration, Artificial