title: Failure of lung isolation by a double-lumen endotracheal tube rescued by the concomitant use of an arndt bronchial blocker under direct visualization.
abstract: Failure of a double-lumen endotracheal tube (DLT) to isolate the lung during thoracic surgery can have significant consequences. In this report, we examine an approach for rescuing a malpositioned DLT. A 37F left-sided DLT was inserted and its proper position confirmed. After positioning, repeat confirmation of position and the ability to achieve 1-lung ventilation were performed, but inadequate isolation of the lung being operated on was noted after incision. A 7-Fr Arndt bronchial blocker was positioned through the tracheal lumen of the DLT to obtain 1-lung ventilation. This technique can be used to rescue a malfunctioning DLT without the need for extubating and reintubating the trachea.
authors.affiliation: From the *Department of Anesthesiology, Thomas Jefferson University, Philadelphia; and †Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Beam
authors.forename: Stephen O
authors.initials: SO
authors.lastname: Bader