One-lung ventilation with pediatric Arndt endobronchial blocker in an adult patient with tracheal stenosis: A case report

Lee, Do Won; Hong, Jung Min; Park, Ju Hee; Kim, Hae Kyu

Case Report

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2011;6(4):353-356.
Published online October 31, 2011.

One-lung ventilation with pediatric Arndt endobronchial blocker in an adult patient with tracheal stenosis: A case report

Do Won Lee, Jung Min Hong, Ju Hee Park, Hae Kyu Kim

Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Korea. ccarrot@ pusan.ac.kr

Abstract

In thoracic surgery, functional isolation of the lungs can be accomplished by several methods. However, for patients with tracheal stenosis, only limited choices are available to achieve one-lung ventilation (OLV) because of the difficulties posed by the stenotic trachea. In our patient, the narrowest site in the trachea was as small as 9.3 mm in diameter, and therefore a 28 Fr double-lumen endotracheal tube (DLT) or a Univent tube (inner diameter [ID] 6.0 mm) could not be inserted into the trachea. Recently, 7 and 9 Fr Arndt endobronchial blockers (AEB) used in adults could not even be used in our patient. Here we report a case of successful OLV that was performed using a pediatric wire-guided AEB and a small diameter single lumen endotracheal tube (SLT). We believe that this pediatric AEB is a safer and more effective option for achieving OLV in adult patients with tracheal stenosis.

Key Words: Arndt endobronchial blocker, One lung ventilation, Tracheal stenosis