Airway management during anesthesia for double-lung transplantation using a single-lumen endotracheal tube with an enclosed bronchial blocker

Abstract

The approach to airway management in patients undergoing lung transplantation is dependent on the type of transplant procedure (combined heart-lung, single-lung, or double-lung technique), the site of the airway anastomosis (trachea or mainstem bronchus), and whether cardiopulmonary bypass (CPB) will be used. Modifications of the original operative technique for double-lung transplantation 1,2 have been introduced recently including the use of bilateral bronchial anastomoses 3 and sequential single-lung transplantation. 4 The respective advantages of these techniques include the improved collateral blood supply at the donor bronchial anastomosic sites, thereby decreasing the risk of ischemic airway complications, and the potential elimination of the need for CPB. Specific strategies for airway management during double-lung transplantation have not been previously addressed. This report describes recent experience with a patient who underwent double-lung transplantation without CPB using a single-lumen endotracheal tube with enclosed bronchial blocker (Univent tube, Fuji Systems Corporation, Tokyo, Japan).