Use of the wire-guided endobronchial blocker for one-lung anesthesia in patients with airway abnormalities

Abstract

ONE-LUNG VENTILATION (OLV) in the thoracic surgical patient can be achieved with the use of a double-lumen endotracheal tube (DLT) or bronchial blockade with a Univent tube (Vitaid LTD, Lewiston, NY), a Fogarty occlusion catheter (Edwards Lifesciences, Irvine, CA), or a wire-guided endobronchial blocker (Arndt blocker; Cook Critical Care, Bloomington, IN).1,2 OLV techniques may be complicated in these patients because of the uncommon occurrence of carcinoma of the pharynx, tongue, or epiglottis, which makes intubation difficult. In addition, some of these patients have received prior neck radiation therapy and extensive neck/tracheal surgery. All of these problems make the airway management more complex and challenging. The authors report 4 cases in which the upper and/or lower airway anatomy have been previously distorted because of surgery or radiation; in all cases successful OLV was achieved with the use of the Arndt blocker.