Wire-guided endobronchial blockade in a patient with a limited mouth opening

We report the use of wire-guided endobronchial blockade, a new method of achieving one-lung ventilation, in a patient requiring awake, nasal, fibreoptic intubation for resection of a lung carcinoma.

A 43-yr-old woman with limited mouth opening, from severe TMJ dysfunction, required a right thoracotomy for right upper lobe wedge resection. One-lung ventilation was accomplished using a new type of wire-guided endobronchial blocker. The device was placed coaxially through the endotracheal tube using a pediatric bronchoscope through a special bronchoscopy port.

Effective one-lung ventilation was achieved using this system. The system may prove advantageous in clinical situations where placement of double lumen endotracheal tubes or Univent tubes is technically impractical or impossible.