Book chapter
Chapter 16 - Separation of the Lung: Double-Lumen Endotracheal Tubes and Endobronchial Blockers
Cohen’s Comprehensive Thoracic Anesthesia, pp.213-239
Elsevier Inc
2022
DOI: 10.1016/B978-0-323-71301-6.00016-0
Abstract
Lung separation techniques are designed to facilitate surgical exposure and provide one-lung ventilation (OLV) in patients undergoing thoracic, mediastinal, cardiac, vascular, esophageal, or selective spine surgery. Lung separation can be achieved with two different techniques. The first involves the double-lumen endotracheal tube (DLT) technique. This device is made of disposable polyvinyl, chloride or silicone material. The DLT is a bifurcated tube with both an endotracheal and an endobronchial lumen and can be used to achieve separation of either the right or left lung. Modifications have been made to the DLT to improve quality of placement and patient safety. A newly designed VivaSight® DLT has an integrated camera, allowing continuous visualization of its position within the trachea. In addition, there is the ECOM-DLT®. This device has multiple flexible surface sensors attached to the endotracheal cuff of the DLT that, when connected to a monitor measure the aortic blood flow by the bioimpedance method, and based upon an algorithm, it can record cardiac output, stroke volume, and systemic vascular resistances. The second technique involves blockade of a mainstem bronchus to allow lung collapse distal to the occlusion. Currently, there are different bronchial blockers to facilitate lung separation and provide OLV. These devices are either attached to a single-lumen endotracheal tube with an enclosed bronchial blocker, such as the torque control blocker Univent or can be used independently while advanced over a single-lumen endotracheal tube, such as the wire-guided endobronchial blocker (Arndt blocker), the Cohen tip-deflecting endobronchial blocker, the Fuji Uniblocker, or the EZ-Blocker.
Details
- Title: Subtitle
- Chapter 16 - Separation of the Lung: Double-Lumen Endotracheal Tubes and Endobronchial Blockers
- Creators
- Javier H. Campos
- Resource Type
- Book chapter
- Publication Details
- Cohen’s Comprehensive Thoracic Anesthesia, pp.213-239
- DOI
- 10.1016/B978-0-323-71301-6.00016-0
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 2022
- Academic Unit
- Anesthesia
- Record Identifier
- 9984295917002771
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