부산대학교 도서관

Shortly after repair of a type A aortic dissection, resternotomy was required because of tamponade. During the exploration, it was discovered that the source of bleeding was in the right pleura. Collapse of the right lung was requested. A double-lumen tube would have necessitated changing the endotracheal tube (ETT) in an unstable patient in the middle of surgery. Instead, a Coopdech endobronchial blocker was passed into the right lung through the lumen of the in situ ETT. To ensure that the blocker did not migrate into the trachea, it was deliberately passed through the Murphy eye of the ETT, which had been deliberately passed distally to almost touch the carina. This arrangement provided reliable right-lung collapse to facilitate right pleural hemostasis. Keywords Aortic dissection * Cardiac surgery * Endobronchial blocker * One-lung anesthesia
All anesthesiologists should have a strategy for providing expedient and reliable lung isolation in a patient whose trachea has already been intubated with a standard endotracheal tube (ETT). We recently [...]