The Use of Bronchial Blockers for Providing One-Lung Ventilation

The use of BBs as a means for providing OLV has grown. There are multiple choices of BB that are currently available and have been discussed in this review. The use of a BB can be especially advantageous in a patient with a difficult airway in whom a SLT can be used and then will not have to be changed. Whether a DLT or BB is chosen as the technique, it is important that the practitioner be familiar with the device.22 The ABCs of lung isolation that must be adhered to have been described by Peter Slinger as A: anatomy (know the anatomy); B: bronchoscopy (be skilled in, and use bronchoscopy); and C: chest imaging (review the chest imaging to learn of possible airway abnormalities).52 There may be added time and cost when using a BB, but patient safety always should come first.53 Avoiding having to change from an SLT to a DLT may be the primary safety issue in a patient who is considered to be a difficult intubation, and a BB may be preferred in these situations.54,55 This would be especially true if there are also concerns with mask ventilation, such as in a morbidly obese patient; mask ventilation or placement of an LMA might become necessary as the backup if the tube exchange was not successful. © 2009 Elsevier Inc. All rights reserved.