Bending the rules: a novel approach to placement and retrospective experience with the 5 French Arndt endobronchial blocker in children

Summary BackgroundOne‐lung ventilation (OLV) is frequently employed to improve surgical exposure during video‐assisted thoracoscopic surgery (VATS) and thoracotomy in adults and children. Because of their small size, children under the age of 2 years are not candidates for some of the methods typically used for OLV in adults and older children, such as a double‐lumen endotracheal (DLT) tube or intraluminal use of a bronchial blocker. Due to this, the clinician is left with few options. One of the most robust approaches to OLV in infants and small children has been the extraluminal placement of a 5 French (5F) Arndt endobronchial blocker (AEB). AimThe aim of this retrospective study was to examine and describe our experience with placement and management of an extraluminal 5F AEB for thoracic surgery in children
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: Research Report Source Type: research

Related Links:

Conclusion: CT-measured bronchial width predicts the appropriate DLT size better than conventional method. In the absence of CT scan facility, patient height, age, and chest X-ray TW may be used to predict DLT size with reasonable accuracy. PMID: 31621669 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
We report the case of an adult patient with a lung tumor that was growing rapidly and hemorrhaging; thus, a thoracotomy for lung resection should have been performed as early as possible. However, a large mass on the glottis obstructed the entry of the double-lumen tube or bronchial blocker. Therefore, the operation could not be performed because of the inability to provide one-lung ventilation via the conventional intubation method. Diagnoses: Computed tomography (CT) revealed a lung tumor that was growing rapidly and preoperative bronchoscopy showed a large mass on the vocal cords. Interventions: After anesthesia i...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusions: Dye marking using r-EBUS and virtual bronchoscopy can be easily and safely performed to localize small pulmonary nodules immediately before minimally invasive resection.Respiration
Source: Respiration - Category: Respiratory Medicine Source Type: research
The objective of this study was to evaluate the feasibility of pleural dye marking using radial-EBUS (r-EBUS) combined with virtual bronchoscopy (VB) to help minimally invasive resection of small peripheral lung nodule (SPLN) or ground glass opacities (GGOs).Methods: Both bronchial path to nodule (LungPoint Software®) and sub-pleural methylene blue deposition were performed in the operating room immediately before minimally invasive surgery. A 4 mm fiberscope with a 2mm working channel, 1.4 mm r-EBUS probe and guide sheath were used under general anesthesia without fluoroscopy guidance, in a patient on operating positi...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research
Renu Sinha, Anjan Trikha, Rajkumar SubramanianSaudi Journal of Anaesthesia 2017 11(4):490-493 A 15-year-old boy, weighing 45 kg, 160 cm height with large anterior mediastinal mass and significant tracheal narrowing was scheduled for thoracotomy and excision of the mass. He had a history of progressive dyspnea, inability to lie supine, and a right upper hemithorax mass 13 cm × 13 cm × 11 cm as evident on a computerized tomography with significant compression of the trachea and right main stem bronchus. Inhalational induction was carried out using sevoflurane with 100% oxygen. After achieving adequate depth of...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
CONCLUSION:Bronchoscopy, performed for tracheobronchial foreign body aspiration, carries a potential life-threatening risk during and after the process. The clinician needs to be aware of these risks, take proper precautions, and perform bronchoscopy by taking the medical condition of the patient and characteristics of the inspired foreign body into consideration.Ann Saudi Med 2006;26(4):283-287
Source: Annals of Saudi Medicine - Category: General Medicine Tags: ISSUE 4 Source Type: research
WM Hajjar, RS Aljurayyad, NI Al-Jameel, IS Shaheen, SA Al-NassarSaudi Journal of Anaesthesia 2016 10(4):465-467Bronchial foreign body aspiration (BFBA) is not a rare incident in children. It can be managed successfully with flexible bronchoscopy in most of the cases, except for some cases, which require rigid bronchoscopy or even surgical intervention such as thoracotomy. Here, we report an unusual case of BFBA of metallic dental bur in a healthy 24-year-old dental nurse assistant, who was herself undergoing a dental procedure to remove dental caries, and suddenly the foreign body which was “diamond metallic dental b...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
We report a 37-year-old female involved in MVA presented to the emergency room (ER) with normal vital signs. Ten minutes later, her saturation dropped to 75%, which required ventilation; however, two attempts for endotracheal intubation failed. The third time frova airway intubating introducer used and succeeded. Immediately after tracheal intubation, the patient started to have extensive subcutaneous emphysema and severe hypoxia; chest X-ray showed right side tension pneumothorax which was not relieved by a chest tube insertion. Bronchoscopy confirmed total transection of the right main bronchus and lower tracheal lac...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Authors: Fang N, Sun L, Zhang Y, Zhu W, Wang X Abstract Foreign body aspiration is a life-threatening emergency in children. An 11-year-old girl presented at the emergency department with a case of accidental foreign body aspiration. The patient had symptoms of acute respiratory distress followed by cyanosis of the lips. Radiological examination demonstrated a radiopaque foreign body. Under analgesic and amnestic anesthesia, we extracted the metal bead using alligator forceps, with a direct laryngoscope and a flexible bronchoscope. This method afforded an improved visual access to the operative field and allowed fo...
Source: Minimally Invasive Therapy and Allied Technologies - Category: Surgery Tags: Minim Invasive Ther Allied Technol Source Type: research
Abstract The Arndt blocker is positioned in the desired bronchus using a wire loop which couples the blocker with a fiberoptic bronchoscope (FOB). The wire loop once removed cannot be reinserted in 5F and 7F blockers making repositioning of the blocker difficult. A 34-year-old female was to undergo left thoracotomy followed by laparoscopic cholecystectomy. The left lung was isolated with a 7F Arndt bronchial blocker. During one-lung ventilation, the wire loop was removed for oxygen insufflation. There was loss of lung isolation during the procedure and dislodgement of the blocker was confirmed by FOB. The initial ...
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
More News: Anesthesia | Anesthesiology | Bronchoscopy | Cardiovascular & Thoracic Surgery | Children | Pediatrics | Respiratory Medicine | Study | Thoracotomy