Abstract
Whilst a double lumen tube (DLT) is the gold standard for one lung ventilation, its double curvatures and increased diameter can make intubation difficult, potentially compounded by a challenging airway. We describe the successful placement of DLT in a difficult airway, and confirmation of the appropriate placement of DLT by using flexible paediatric video-ureteroscope (digital Olympus URF-V2/V2R), without which the purpose of achieving lung isolation was not possible.
Highlights
Selective lung ventilation is required for many thoracic surgeries
The position of double lumen tube (DLT) was confirmed by auscultation and inspection of chest rise in earlier years, which can be confirmed with the help of fibre optic bronchoscope[2]
DLT and bronchial blocker have made lung separation easy and safe but achieving one-lung ventilation with placement and confirmation of DLT in difficult airway with limited resources is a great challenge for the attending anaesthesiologist
Summary
Selective lung ventilation is required for many thoracic surgeries. Bronchial blockers and DLTs are preferred to perform one-lung ventilation. Achieving one-lung ventilation with a difficult airway for thoracic surgeries requires experienced anaesthesiologists as well as necessary equipment. One lung ventilation with the placement of DLT in a difficult airway in a setting with limited resources is a further challenge for the attending anaesthesiologist.[1] The position of DLT was confirmed by auscultation and inspection of chest rise in earlier years, which can be confirmed with the help of fibre optic bronchoscope[2].
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