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Lung Separation in the Morbidly Obese Patient
Journal article   Open access   Peer reviewed

Lung Separation in the Morbidly Obese Patient

Javier H Campos and Kenichi Ueda
Anesthesiology research and practice, Vol.2012, pp.207598-5
2012
DOI: 10.1155/2012/207598
PMCID: PMC3287015
PMID: 22400021
url
https://doi.org/10.1155/2012/207598View
Published (Version of record) Open Access

Abstract

Lung separation techniques in the morbidly obese patient undergoing thoracic or esophageal surgery may be at risk of complications during airway management. Access to the airway in the obese patient can be a challenge because they have altered airway anatomy, including a short and redundant neck, limited neck extension and accumulation of fat deposition in the pharyngeal wall contributing to difficult laryngoscopy. Securing the airway is the first priority in these patients followed by appropriate techniques for lung separation with the use of a single-lumen endotracheal tube and a bronchial blocker or another alternative is with the use of a double-lumen endotracheal tube. This review is focused on the use of lung isolation devices in the obese patient. The recommendations are based upon scientific evidence, case reports or personal experience. Fiberoptic bronchoscopy must be used to place and confirm proper placement of a single-lumen endotracheal tube, bronchial blocker or double-lumen endotracheal tube.
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