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Advanced bronchoscopic procedures
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
Karthik Balakrishnan, R. Paul Boesch
The endobronchial blocker (or “bronchial blocker”) is essentially a balloon catheter designed to occlude rather than dilate an airway lumen. These devices are usually used intraoperatively for lung operations in patients for whom double-lumen endotracheal tubes are not a viable option, often due to size limitations.10 Bronchial blockers may take more time to place and are more likely malpositioned than double-lumen endotracheal tubes, but carry less risk of sore throat, hoarseness, and mild airway injury.11 Bronchial blockers may also be used to temporarily isolate lung regions for bronchopleural fistulae or airway hemorrhage, though, in the authors' experience, they do not generally maintain position and seal for long enough to provide useful temporization.
Abdominal surgery
Published in Brian J Pollard, Gareth Kitchen, Handbook of Clinical Anaesthesia, 2017
Brian J Pollard, Gareth Kitchen
The most common technique is GA supplemented by epidural analgesia. Agents with rapid recovery profiles are useful to avoid prolonged postoperative respiratory depression. Unlike the volatile agents, propofol does not inhibit hypoxic pulmonary vasoconstriction, and may therefore confer a small benefit. A left-sided double-lumen endobronchial tube or a single-lumen tube with an endobronchial blocker is inserted to allow one-lung ventilation, which may be prolonged. Active patient warming is required.
Implications of endotracheal tube placement in a patient with a true tracheal bronchus
Published in Baylor University Medical Center Proceedings, 2019
Russell K. McAllister, Christopher Sirianni, Richard Beckendorf
The use of an endobronchial blocker device is an additional management tool once the anomaly is recognized. However, several case reports have made cogent arguments in favor of using a DLT as opposed to the variety of endobronchial blocking devices in the case of true tracheal bronchus. DLT enables administration of continuous positive airway pressure to the operative lung and provides a conduit for suctioning and visualization without interruption of oxygenation and ventilation.3,4
Cast of the left bronchial tree
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Marwa Oudah, Hargeet Sandhu, Fattoumata Sissoho, Bruce Sabath
The bronchoscopic management of hemoptysis includes clearing the airways of blood to maintain adequate ventilation and placement of an endobronchial blocker to isolate the bleeding lung until a more definitive intervention can take place [6]. For proximal airway bleeding, thermal ablative techniques and other local therapies can be used. Peripheral bleeding that cannot be reached bronchoscopically often requires angiographic embolization [7].