Chapter 6 - Lung isolation

Summary

This chapter provides an overview of the indications and techniques available for lung isolation in adult patients, using devices currently available in the UK. The double lumenendobronchial tube (DLT), bronchial blocker and an appropriately sized single lumen tracheal tube can all produce lung isolation, if placed in a main stem bronchus. There are two main configurations of bronchial blockers: the blocker is incorporated into a channel in the wall of a tracheal tube as in univent torque control blocker (TCB); and independent catheter as in Arndt Blocker. The independent bronchial blocker catheters can all be positioned coaxially down a standard tracheal tube under fiberoptic bronchoscope (FOB) guidance. Complications with the use of bronchial blockers include malposition and displacement resulting in life-threatening airway obstruction and hypoxia. Single lumen tracheal tubes, standard DLTs and bronchial blockers have all been used to provide lung isolation in patients with tracheostomy.