Review of difficult airway management in thoracic surgery

Granell, M.; Parra, M.; Jiménez, María José; Gallart, L.; Villalonga, A; Valencia, O.; Unzueta, M.C.; Planas, Antonio; Calvo, Javier Martínez

doi:10.1016/j.redare.2017.11.013

Cited by 14 publications

(12 citation statements)

References 43 publications

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Section: Discussionmentioning

confidence: 99%

Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

Duan

2019

Preprint

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Background Lung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special ventilation strategy. Case presentation A 48-year-old woman was going to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS) who had left pneumonectomy two years ago. A 32-French left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff’s inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma. Conclusion Lung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the promotion of the operation could be solved.

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Section: Discussionmentioning

confidence: 99%

Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

Duan

2019

Preprint

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“…Another approach is BB. BB can be served for the purpose of one lung ventilation and selective lobar blockade in VATS, and also its advantages in children and difficult airway placement are widely-accepted [4]. As for this case, however, if BB were chosen, it should be placed into the right upper lobe bronchus, given the knowledge of the anatomical features, it would be more likely placed into some segmental bronchus of the right upper lobe, resulting in inflation in the right upper lobar; besides, even if by any chance, BB were suitably placed, it would have a great probability of being dispositioned given the thought of the short right upper lobe bronchus and the surgical intervention; and more importantly, the drainage of the blood and sputum from the upper lobe would be minimal which could be deadly to this patient because of the contamination and the spread of tumor.…”

Section: Discussionmentioning

confidence: 99%

Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

Duan

2019

Preprint

View full text Add to dashboard Cite

Background: Lung resection after previous contralateral pneumonectomy is rare. We present a case of right anterior segmentectomy despite previous left pneumonectomy, demanding special airway management strategy. Case presentation: A 48-year-old woman was going to have the right anterior segmentectomy through uniportal video-assisted thoracoscopy (VATS) who had left pneumonectomy two years ago. A 32-French left-sided double-lumen endobronchial tube (DLT) was chosen and adapted. The DLT was intubated into the bronchus intermedius. And the upper lobe can be isolated from the ventilation in the middle and lower lobes when the bronchial cuff’s inflated. The perioperative period was uneventful and the pathological diagnosis was adenocarcinoma. Conclusion: Lung cancer radical resection was discouraged after previous contralateral pneumonectomy partly due to the challenging ventilation and isolation. With this new DLT adapting and intubation technique showed in this case, the challenging ventilation and isolation that deter the promotion of the operation could be solved.

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“…Si se trata de una vía aérea difícil (VAD), existen guías publicadas al respecto 5 , pero en pacientes covid-19 hay recomendaciones diferentes 1 ; la intubación con paciente despierto en J o u r n a l P r e -p r o o f VAD prevista no está recomendada, y se reservará para casos de urgencia no diferible o emergencias, recomendándose aplicar una sedación suave intravenosa y evitar topicalizar la vía aérea. En la VAD imprevista, tras un máximo de 3 intentos de IOT fallidos, se procederá a asegurar la vía aérea con algún dispositivo supraglótico de 3ª generación y posterior intubación con broncoscopio flexible.…”

Section: J O U R N a L P R E -P R O O Funclassified

Análisis y revisión del manejo perioperatorio del paciente COVID-19 en la cirugía torácica

Granell

Sanchís

Romero

et al. 2021

Revista Española de Anestesiología y Reanimación

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Debido a la grave situación de pandemia que vivimos causada por el COVID-19, la Sección de Anestesia Cardiaca, Vascular y Torácica de la SEDAR pretende dar información de los aspectos más relevantes a considerar en pacientes con sospecha o infección confirmada por coronavirus que van a ser sometidos a cirugía torácica. Creemos que es esencial mantener una óptima transmisión de información para llevar a cabo maniobras seguras, tanto para los pacientes como para el personal sanitario. La estrategia de manejo debe basarse en una organización exquisita del trabajo, definiendo quién, cómo y cuándo va a realizar cada tarea y procedimiento. Las recomendaciones que se proponen, tras valorar el riesgo-beneficio en el escenario específico de la cirugía de tórax y la experiencia de expertos en torácica obtenida en el estudio COV2-VIAEREA, tratan de asesorar sobre los aspectos anestésicos claves a tener en cuenta ante una eventual necesidad de cirugía torácica en el contexto de la pandemia por COVID-19.

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Review of difficult airway management in thoracic surgery

Cited by 14 publications

References 43 publications

Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

Airway Management of the Right Anterior Segmentectomy through Uniportal Video-Assisted Thoracoscopic Surgery (VATS) after Left Pneumonectomy by An Adapted Double-lumen Endobronchial Tube (DLT): A Case Report

Análisis y revisión del manejo perioperatorio del paciente COVID-19 en la cirugía torácica

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