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Updated: Jul 29, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
One-lung ventilation when intubation is difficult--presentation of a new endobronchial blocker
G A Arndt1, S T DeLessio, P W Kranner
1Department of Anesthesiology, University of Wisconsin Clinical Sciences Center, Madison, USA.
Background:
One-lung ventilation utilizing a double-lumen endotracheal tube may be technically difficult or inappropriate in morbidly obese or critically ill patients. In patients requiring awake fiberoptic intubation, double-lumen tube placement may be impossible. Wire-guided endobronchial blockade through a conventional endotracheal tube is a new alternative for these patients.
Methods:
A 44-year-old, 133 kg female patient was scheduled to undergo a thoracotomy for transthoracic fundoplication. A wire-guided endobronchial blocker (WEB) was placed following rapid-sequence induction and intubation with an 8.0 OD single-lumen endotracheal tube with the aid of a pediatric bronchoscope.
Results:
The WEB, using a guiding loop, was placed with ease and allowed effective one-lung ventilation.
Conclusion:
The WEB system allows one-lung ventilation to be achieved with a conventional endotracheal tube. The need for reintubation at the end of surgery is eliminated and endotracheal tube cross-sectional area is conserved.
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