One-lung ventilation with a bronchial blocker in thoracic patients

Area of Science:

• Thoracic Surgery
• Anesthesiology
• Pulmonary Medicine

Background:

• Lung isolation is crucial for thoracic surgeries, enabling single-lung ventilation and improved surgical access.
• Bronchial blockers (BBs) are accepted for lung isolation but are not the primary choice for anesthesiologists.
• This study evaluates the safety and efficacy of BBs in various thoracic procedures.

Purpose of the Study:

• To assess the safety and efficacy of bronchial blockers (BBs) in achieving lung collapse across diverse thoracic surgeries.
• To identify factors influencing the success rate of lung collapse using BBs.
• To determine complication rates associated with BB use in thoracic procedures.

Main Methods:

• Retrospective and descriptive analysis of 134 patients undergoing thoracic surgery between 2015 and 2022.
• Exclusion criteria included massive hemoptysis, empyema, or prior pneumonectomy.
• Data collected on patient demographics, surgical type, BB placement, lung collapse quality, and complications.

Main Results:

• Excellent or good lung collapse was achieved in 97% of cases (63.9% excellent, 33.1% good).
• Over 90% of patients experienced no intraoperative or immediate postoperative complications.
• Excellent lung collapse was more frequent in VATS surgeries, lateral decubitus positioning, and left main bronchus BB placement (p < 0.05).

Conclusions:

• Bronchial blockers (BBs) are a safe and effective alternative for achieving pulmonary collapse in various thoracic procedures.
• BBs demonstrate satisfactory safety rates with minimal complications.
• The study supports the use of BBs as a viable option for lung isolation in thoracic surgery.