European Society of Anaesthesiologists; 8th Annual Meeting with the Austrian International Congress; Vienna, Austria, 1-4 April 2000
Background and goal of study: One lung ventilation (OLV), may be required in patients undergoing thoracic aneurysm repair (TAA) to allow exposure of the aneurysm. We report the use of the wire-guided endobronchial blocker (WEB), to allow left OLV to facilitate aneurysm exposure.
Materials and methods: The WEB, Cook Inc., Bloomington, indiana is a new system to achieve one lung ventilation (OLV), by using a conventional endotracheal tube. The WEB system incorporates two components: the WEB and the special bronchoscopy port (SBP). The SBP allow simultaneous bronchoscopy, endobronchial blockade and ventilation. The WEB is nine fr double lumen catheter having a guide-wire loop to couple the WEB and a pediatric bronchoscope, 3.4 mm OD Pentax, Tokyo, Japan (FOB). The WEB is introduced through the SBP in the anaesthesia circuit. The WEB is placed by advancing a FOB through the guide-wire loop and into the airway segment to be blocked. The WEB is then advanced over the FOB to the position to be blocked. The balloon is inflated to achieve one-lung ventilation. The WEB system was used in four TAA patients. Informed consent was obtained following a University of Wisconsin IRB protocol.
The WEB was placed correctly in all patients in the left side.
Conclusion: Patients undergoing TAA repair commonly require left OLV and postoperative intubation. The WEB system allows OLV to be achieved with a conventional endotracheal tube avoiding reintubation. At the conclusion of surgery, the WEB system is removed leaving a conventional endotracheal tube. The requirement for OLV is independent of the device installed in the airway. The WEB system may offer a significant advantage to patients undergoing OLV in which postoperative intubation is required.
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