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Chapter 27 - Lung Separation

from Section 2 - Airway Management: Clinical Settings and Subspecialties

Published online by Cambridge University Press:  03 October 2020

By
Jay B. Brodsky
Edited by
Tim Cook  and
Michael Seltz Kristensen
Tim Cook
Affiliation:
Royal United Hospital, Bath, UK
Michael Seltz Kristensen
Affiliation:
Rigshospitalet, Copenhagen University Hospital, Denmark
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Summary

For many thoracic operations lung separation to enable collapse of the operated lung is either necessary or useful for successful surgery. Lung separation may also be required in other settings for management of pulmonary bleeding, infection or complicated lung ventilation. Lung separation requires knowledge, skill and attention to detail. New technology including videolaryngoscopy, tracheal tubes incorporating distal cameras and improvements in bronchial blocker technology have added to the anaesthetist’s armamentarium. This chapter describes the indications, techniques and complications of lung separation of relevance to generalist and specialist anaesthestists.

Keywords

Airwaybronchial blockerdouble-lumen tubelung separation
Type
Chapter
Information
Core Topics in Airway Management , pp. 243 - 249
Publisher: Cambridge University Press
Print publication year: 2020

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References

Further Reading

Benumof, JL, Partridge, BL, Salvatierra, C, et al. (1987). Margin of safety in positioning modern double-lumen endotracheal tubes. Anesthesiology, 67, 729–738.CrossRefGoogle ScholarPubMed
Brodsky, JB. (2009). Lung separation and the difficult airway. British Journal of Anaesthesia, 103(Suppl 1), i66–i75.CrossRefGoogle ScholarPubMed
Brodsky, JB. (2015). Con: a bronchial blocker is not a substitute for a double-lumen endobronchial tube. Journal of Cardiothoracic and Vascular Anesthesia, 29, 237–239.Google Scholar
Brodsky, JB, Lemmens, HJ. (2003). Left double-lumen tubes: clinical experience with 1,170 patients. Journal of Cardiothoracic and Vascular Anesthesia, 17, 289–298.Google Scholar
Fitzmaurice, BG, Brodsky, JB. (1999). Airway rupture with double-lumen tubes. Journal of Cardiothoracic and Vascular Anesthesia, 13, 322–329.CrossRefGoogle ScholarPubMed
Narayanaswamy, M, McRae, K, Slinger, P, et al. (2009). Choosing a lung isolation device for thoracic surgery: a randomized trial of three bronchial blockers versus double-lumen tubes. Anesthesia & Analgesia, 108, 1097–1101.Google Scholar
Schuepbach, R, Grande, B, Camen, G, et al. (2015). Intubation with VivaSight or conventional left-sided double-lumen tubes: a randomized trial. Canadian Journal of Anaesthesia, 62, 762–769.CrossRefGoogle ScholarPubMed

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