Abstract
We describe the insertion of the double lumen endobronchial tube (DLT) using a non-channeled standard blade of the King Vision (TM) videolaryngoscope for one lung ventilation (OLV) in a morbidly obese patient with a predicted difficult airway, severe restrictive pulmonary function, asthma, and hypertension. The patient was scheduled for a video-assisted thoracoscopic lung biopsy. The stylet of the DLT was bent to fit the natural curve of the #3 non-channeled blade of the King Vision (™) videolaryngoscope. We conclude that the use of King Vision (™) videolaryngoscope could offer an effective method of DLT placement for OLV.
Highlights
The GlideScope® (Verathon Inc., Bothell, WA, USA) has been used to facilitate the placement of the double lumen endobronchial tubes (DLT) in patients with a difficult airway[1,2]
In this report we show how the use of the standard non-channeled blade of the King VisionTM videolaryngoscope can be useful for DLT placement, as illustrated in the management of a morbidly obese patient with predicted difficult airway and severely restrictive pulmonary dysfunction
Two main techniques can be used to achieve lung isolation in patients with a predicted difficult airway: [1] using a DLT or [2] using a bronchial blocker inserted through a single-lumen tube (SLT)
Summary
The GlideScope® (Verathon Inc., Bothell, WA, USA) has been used to facilitate the placement of the double lumen endobronchial tubes (DLT) in patients with a difficult airway[1,2]. The King VisionTM video laryngoscope (King Systems, Indianapolis, IN, USA) is a portable video laryngoscope (VL) similar to the Pentax Airway Scope® (Pentax-AWS, Hoya Corp., Tokyo, Japan), but different in that the LED light and CMOS camera are part of the disposable blades These blades are available in two styles: a standard non-channeled blade that requires the use of a stylet shaped to 60–70° to direct the SLT, and a channeled blade that incorporates a guide channel which directs the SLT towards the glottis. In this report we show how the use of the standard non-channeled blade of the King VisionTM videolaryngoscope can be useful for DLT placement, as illustrated in the management of a morbidly obese patient with predicted difficult airway and severely restrictive pulmonary dysfunction. A second laryngoscopy with the introduction of the standard blade of a King VisionTM VL through the mouth followed with gliding of the left DLT over the posterior surface of the standard non-channeled blade. A post-operative follow-up (for the six days after surgery) showed no evidence of hoarseness
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