An initial experience with an Extraluminal <scp>EZ</scp>‐Blocker<sup>®</sup>: A new alternative for 1‐lung ventilation in pediatric patients

Templeton, T. Wesley; Templeton, Leah B.; Lawrence, Ann E.; Sieren, Leah M.; Downard, Martina G.; Ririe, Douglas G.

doi:10.1111/pan.13342

Cited by 15 publications

(12 citation statements)

References 10 publications

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“…First, the EZB is initially designed for adult patients and thus only available in one size. Although extraluminal placement of an EZB can be successfully used to provide lung isolation in children down to 6 years of age [ 20 ], we use an Arndt Endobronchial Blocker for pediatric patients. The 5-French Arndt Endobronchial Blocker can be used as a consistent, safe method of single lung ventilation in most young children.…”

Section: Discussionmentioning

confidence: 99%

The EZ-blocker for one-lung ventilation in patients undergoing thoracic surgery: clinical applications and experience in 100 cases in a routine clinical setting

Moritz

Irouschek

Birkholz

et al. 2018

J Cardiothorac Surg

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BackgroundIn certain clinical situations the insertion of a double-lumen tube (DLT) for one-lung ventilation (OLV) is not feasible or unfavorable. In these cases, the EZ-Blocker (EZB) may serve as an alternative. The aim of our analysis was to report on the clinical applications and our experience with the EZB for one-lung ventilation in 100 patients undergoing thoracic surgery.MethodsAll anesthetic records from patients older than 18 years of age undergoing general anesthesia in the department of thoracic surgery with intraoperative use of an EZB for OLV at the University Hospital of Erlangen in four consecutive years were analyzed retrospectively.ResultsMost frequently, EZB was used in difficult airway (27%) and for surgical procedures with high risk for left recurrent laryngeal nerve injury (21%), followed by application in intubated (12%) or tracheostomized (11%) patients. 11% of the patients had an increased risk of gastric regurgitation. Almost all EZBs were placed free of complications (99%). Clinically sufficient lung collapse was achieved in all patients. No serious airway injuries or immediate complications were documented.ConclusionsThe EZB is an efficient, easy-to-use and safe airway device and enables OLV in several clinical situations, when conventional DLTs are not feasible or less favorable. Three major applications were depicted from the data: expected difficult airway, surgical procedures with necessity of intraoperative recurrent laryngeal nerve monitoring and already intubated or tracheostomized patients.

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Section: Discussionmentioning

confidence: 99%

The EZ-blocker for one-lung ventilation in patients undergoing thoracic surgery: clinical applications and experience in 100 cases in a routine clinical setting

Moritz

Irouschek

Birkholz

et al. 2018

J Cardiothorac Surg

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“…There are a variety of techniques available for achieving the lung isolation in the adults and large children, but the options for the infants and small children are limited. [1,[3][4][5][6] A fibreopticallydirected wire-guided 5Fr endobronchial blocker had been developed for lung isolation in infant and small children. [7] When using the coaxial technique, the Arndt endobronchial blocker worked well.…”

Section: Discussionmentioning

confidence: 99%

Selective pulmonary lobe isolation with Arndt pediatric endobronchial blocker for an infant

Chaomeng

Liang²,

Liu³

2019

Medicine

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Introduction: Attaining lung isolation in the infant is a challenge for anesthesia care providers. Pulmonary lobe isolation is more challenging. We describe an approach to performing selective pulmonary lobe isolation using the pediatric endobronchial blocker in an infant in the absence of appropriate auxiliary guidance tool.Patient concerns: An 8-month-old and 9.5 kg male infant was admitted because of repeated cough with fever for 3 months and a large cyst of his right lung for 2 weeks. He had been living in a pastoral area with his parents.Diagnosis: Based on the chest computed tomography (CT) and his history about long-term residence in the pastoral area, this patient's diagnosis was considered as right middle lobe hydatid cyst.Interventions: Guided by a fiberoptic bronchoscope, a cuffed 4.0-mm inside diameter (ID) endotracheal tube was successfully placed into the right main bronchus of this infant. Then, pediatric 5-French (Fr) endobronchial blocker was placed into the right middle and lower lobes through the endotracheal tube without navigation of fiberoptic bronchoscope.Outcomes: Lobe isolation was successfully achieved for right middle lobectomy. This approach allows clinicians to perform lobe isolation in the absence of fiberoptic bronchoscope with very small outer diameter. Conclusion:This technique is relatively easy to use and less dependent on equipment with small outer diameter in the selective pulmonary lobe isolation in infants and small children.Abbreviations: CT = computed tomography, ETCO 2 = end tidal carbon dioxide, ETT = endotracheal tube, Fr = French, ID = inside Diameter, NBP = non-invasive blood pressure, OD = outside diameter, SpO 2 = pulse oximetry.

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“…The EZ-Blocker ® is a Y-shaped, 7 Fr double-cuffed bronchial blocker which terminates in two distal extensions, each of which contains a high-volume, low-pressure cuff that is intended to sit within the main stem bronchi [ Figure 5 ]. [ 40 41 42 ] The distal junction point between the two arms measures 6.5 mm, limiting its use in smaller patients. Although it was designed for adult use, the EZ-Blocker has been employed in children as young as 6 years of age.…”

Section: Intraoperative Managementmentioning

confidence: 99%

Anesthesia for thoracic surgery in infants and children

Murray-Torres

Winch

Naguib

et al. 2021

Saudi Journal of Anaesthesia

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The management of infants and children presenting for thoracic surgery poses a variety of challenges for anesthesiologists. A thorough understanding of the implications of developmental changes in cardiopulmonary anatomy and physiology, associated comorbid conditions, and the proposed surgical intervention is essential in order to provide safe and effective clinical care. This narrative review discusses the perioperative anesthetic management of pediatric patients undergoing noncardiac thoracic surgery, beginning with the preoperative assessment. The considerations for the implementation and management of one-lung ventilation (OLV) will be reviewed, and as will the anesthetic implications of different surgical procedures including bronchoscopy, mediastinoscopy, thoracotomy, and thoracoscopy. We will also discuss pediatric-specific disease processes presenting in neonates, infants, and children, with an emphasis on those with unique impact on anesthetic management.

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An initial experience with an Extraluminal EZ‐Blocker^®: A new alternative for 1‐lung ventilation in pediatric patients

Cited by 15 publications

References 10 publications

The EZ-blocker for one-lung ventilation in patients undergoing thoracic surgery: clinical applications and experience in 100 cases in a routine clinical setting

The EZ-blocker for one-lung ventilation in patients undergoing thoracic surgery: clinical applications and experience in 100 cases in a routine clinical setting

Selective pulmonary lobe isolation with Arndt pediatric endobronchial blocker for an infant

Anesthesia for thoracic surgery in infants and children

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An initial experience with an Extraluminal EZ‐Blocker®: A new alternative for 1‐lung ventilation in pediatric patients

Cited by 15 publications

References 10 publications

The EZ-blocker for one-lung ventilation in patients undergoing thoracic surgery: clinical applications and experience in 100 cases in a routine clinical setting

The EZ-blocker for one-lung ventilation in patients undergoing thoracic surgery: clinical applications and experience in 100 cases in a routine clinical setting

Selective pulmonary lobe isolation with Arndt pediatric endobronchial blocker for an infant

Anesthesia for thoracic surgery in infants and children

Contact Info

Product

Resources

About

An initial experience with an Extraluminal EZ‐Blocker^®: A new alternative for 1‐lung ventilation in pediatric patients