Abstract
The purpose of this retrospective review is to evaluate the safety and efficacy of the bronchial blockers (BBs) used in thoracic anesthesia. We enrolled 302 patients who had a BB placed to achieve one-lung ventilation (OLV). Variables recorded from the anesthetic record included type of device used, type and side of surgery, specific indications for OLV, Mallampati score, route of intubation, and complications related to the use of BBs. The BBs used include the Arndt Wire-guided, Univent, Cohen Flexi-tip, Fogarty catheter, and Fuji. The majority of BBs placed were Arndt (n = 156) or Univent (n = 131). BBs were used significantly more often in thoracoscopic procedures than in thoracotomies (P < 0.01). Of the 251 patients, 216 (86%) had a Mallampati score of I/II and 35 (14%) had a score of III/IV. There were no identified complications related to BBs. In summary, BBs can be safely used to achieve OLV and offer advantages for OLV in specific situations.
Similar content being viewed by others
References
Campos JH. Progress in lung separation. Thorac Surg Clin. 2005;15:71–83.
Brodsky JB, Lemmens HJ. Left double-lumen tubes: clinical experience with 1,170 patients. J Cardiothorac Vasc Anesth. 2003;17:289–98.
Campos JH, Kernstine KH. A comparison of left-sided Broncho-cath® with the torque control blocker Univent® and the wire guided blocker. Anesth Analg. 2003;96:283–9.
Narayanaswamy M, McRae K, Slinger P, Dugas G, Kanellakos GW, Roscoe A, Lacroix M. Choosing a lung isolation device for thoracic surgery: a randomized trial of three bronchial blockers versus double-lumen tubes. Anesth Analg. 2009;108:1097–101.
Campos JH. Effects on oxygenation during selective lobar vs. total lung collapse with or without continuous positive airway pressure. Anesth Analg. 1997;85:583–6.
Soto RG, Oleszak SP. Resection of the Arndt bronchial blocker during stapler resection of the left lower lobe. J Cardiothorac Vasc Anesth. 2006;20:131–2.
Sandberg WS. Endobronchial blocker dislodgement leading to pulseless electrical activity. Anesth Analg. 2005;100:1728–30.
Prabhu MR, Smith JH. Use of Arndt wire-guided endobronchial blocker. Anesthesiology. 2002;97:1325.
Barrick BP, Brandon MW, Zvara DA. Inadequate lung isolation in association with asymmetric inflation of an Arndt bronchial blocker. Anesth Analg. 2010;111:241–2.
Peragallo RA, Swenson JD. Congenital tracheal bronchus: the inability to isolate the right lung with a Univent bronchial blocker tube. Anesth Analg. 2000;91:300–1.
Park HP, Bahk JH, Oh YS, Ham BM. Case report: pulmonary soiling after one-lung ventilation with a bronchial blocker. Can J Anesth. 2002;49:874–6.
Baraka A, Nawfal M, Kawkabani N. Severe hypoxemia after suction of the nonventilated lung via the bronchial blocker lumen of the Univent tube. J Cardiothorac Vasc Anesth. 1996;10:694–5.
Doi Y, Uda R, Akatsuka M, Tanaka Y, Kishida H, Mori H. Damaged Univent tubes. Anesth Analg. 1998;87:732–3.
Campos JH, Kernstine KH. A structural complication in the torque control blocker Univent: fracture of the blocker cap connector. Anesth Analg. 2003;96:626–33.
Neustein SM. Use and limitations of the Cohen endobronchial blocker. J Clin Anesth. 2006;18:400–1.
Thielmeier KA, Anwar M. Complication of the Univent tube. Anesthesiology. 1996;84:491.
Hanley JA, Lippman-Hand A. If nothing goes wrong, is everything all right? Interpreting zero numerators. JAMA. 1983;249:1743–5.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Ueda, K., Goetzinger, C., Gauger, E.H. et al. Use of bronchial blockers: a retrospective review of 302 cases. J Anesth 26, 115–117 (2012). https://doi.org/10.1007/s00540-011-1245-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00540-011-1245-x