Selective lobar bronchial blockade using a double-lumen endotracheal tube and bronchial blocker

We report our experience of a selective lobar bronchial blockade (SLBB) technique with a bronchial blocker (BB) which was employed successfully with a routine double-lumen endotracheal tube (DLT) in three patients. For the first case, we selectively blocked the infected left lower lobe in a surgical patient with a lung abscess in a DLT setting. For the second case, we applied this method to block the right middle and lower lobes in order to assess air leakage from the upper lobe during video-assisted thoracic surgery (VATS). For the third case, selective continuous positive airway pressure (CPAP) to the blocked lobes on the operative side resulted in oxygenation improvement with one-lung ventilation (OLV) in a DLT. This novel technique provides benefits during general thoracic surgery by preventing contamination, providing a better operative field, and improving oxygenation with lobar CPAP.