Efficiency, Efficacy, and Safety of EZ-Blocker Compared with Left-sided Double-lumen Tube for One-lung Ventilation

作者：Jo M. J. Mourisse, Jordi Liesveld, Ad F. T. M. Verhagen, Garance van Rooij, Stefan van der Heide, Olga C.J. Schuurbiers-Siebers, Erik H.F.M. van der Heijden · 发表于：Anesthesiology · 年份：2013 · DOI：10.1097/aln.0b013e3182834f2d · 被引用次数：154 · 研究领域：Airway Management and Intubation Techniques、Respiratory Support and Mechanisms、Tracheal and airway disorders

LUNG isolation techniques are used to facilitate one-lung ventilation (OLV) in patients undergoing thoracic surgery, to protect one lung from contamination or hemorrhage in the contralateral lung, and for differential ventilation of the lungs. Commonly used for lung isolation is a double-lumen tube (DLT), which can be placed using only laryngoscopy and auscultation. It is recommended that bronchoscopy be used to verify the correct position because the incidence of malpositions is high.1–5The major disadvantage of DLTs is the often difficult placement because of the larger diameter; as a consequence, patients often complain of hoarseness or sore throat.6There is also a potential for minor laryngeal, tracheal, and bronchial trauma.6Major traumas such as bronchial ruptures have been described.7Compared with other techniques, a DLT has to be replaced by a single-lumen tube (SLT) if prolonged postoperative ventilation is necessary.Alternatively, a bronchial blocker (BB) can be used for lung isolation. This is a balloon-tipped semirigid catheter. Different types are available (e.g. , the wire-guided endobronchial Arndt blocker [Cook Critical Care, Bloomington, IN], the Cohen flex-tip blocker [Cook Critical Care], and the Univent torque control blocker [Vitaid, Lewiston, NY]. The BB is positioned in a bronchus with the aid of bronchoscopy. A BB is normally placed through the inside of an SLT. These types of blockers are not easy to position and frequently dislocate during reposition...