Utilization of an Endobronchial Blocker Through a Double-Lumen Tube as Rescue for Inadequate One-Lung Ventilation

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Respiratory Medicine

Background:

• Minimally invasive thoracic surgeries require one-lung ventilation (OLV).
• Standard OLV methods include double-lumen endotracheal tubes (DLTs) or endobronchial blockers (EBBs).
• Achieving complete lung isolation with DLTs alone can be challenging, necessitating alternative strategies.

Purpose of the Study:

• To describe a case of successful lung isolation using a unique endobronchial blocker.
• To present an alternative strategy for managing difficult lung isolation during thoracic surgery.
• To highlight the utility of a Y-shaped EBB in conjunction with a DLT.

Main Methods:

• A left-sided DLT was placed for OLV.
• Failure to achieve adequate lung isolation with the DLT alone was encountered.
• A Y-shaped EBB was inserted through the DLT to secure lung isolation.

Main Results:

• The Y-shaped EBB successfully achieved and maintained lung isolation.
• This enabled the continuation of the planned minimally invasive thoracic surgery.
• Troubleshooting was avoided, and no additional equipment was required beyond the Y-shaped EBB.

Conclusions:

• A Y-shaped EBB can be an effective adjunct when DLTs alone fail to provide lung isolation.
• This technique offers a valuable solution for complex airway management in thoracic surgery.
• The use of a Y-shaped EBB can facilitate minimally invasive thoracic procedures by ensuring reliable OLV.