A Technique to Intubate a Single Lung Using Combined Endotracheal Tubes When a Standard Endotracheal Tube is Inadequate

Abstract

Massive hemoptysis is a life-threatening emergency encountered by bronchoscopists. Oftentimes stabilizing these patients requires use of selective lung intubation. We present 2 cases of massive hemoptysis secondary to malignancies. Both cases required an extralong endotracheal tube to accomplish selective lung isolation. We used a unique technique of constructing an extralong endotracheal tube from 2 regular endotracheal tubes at the bedside. The extralong endotracheal tube was guided bronchoscopically into the left mainstem bronchus allowing us to selectively intubate the patient's uninvolved lung. Given this ongoing experience, development of an array of extended length endotracheal tubes should be considered. Until that time comes, our technique may be useful to others in managing this very difficult clinical situation.