PDF(Pubmed)
Abstract：
BACKGROUND: Double-lumen tubes (DLTs) and bronchial blockers (BBs) can be used to establish one-lung ventilation (OLV) for thoracic surgery. BBs are a good alternative when DLTs are not suitable or patients have difficult airways. However, BBs are more prone to malposition, leading to adverse events.
METHODS: We present a 68-year-old male patient who was scheduled for thoracoscopic left lower lobectomy. The patient was not expected to have airway malformation preoperatively. When the DLT could not be inserted into the bronchus after general anesthesia induction, we used a BB to perform OLV. During surgery, malposition of the BB resulted in the development of an \"incomplete balloon valve\", leading to a cardiopulmonary crisis.
CONCLUSIONS: Previewing chest computed tomography scans to assess the airway anatomy before thoracic surgery is essential. Three-dimensional reconstruction of the airway can provide a more intuitive assessment of airway anatomy. During OLV with BBs, we should pay attention to balloon malposition to prevent cardiopulmonary crises.
METHODS: We present a 68-year-old male patient who was scheduled for thoracoscopic left lower lobectomy. The patient was not expected to have airway malformation preoperatively. When the DLT could not be inserted into the bronchus after general anesthesia induction, we used a BB to perform OLV. During surgery, malposition of the BB resulted in the development of an \"incomplete balloon valve\", leading to a cardiopulmonary crisis.
CONCLUSIONS: Previewing chest computed tomography scans to assess the airway anatomy before thoracic surgery is essential. Three-dimensional reconstruction of the airway can provide a more intuitive assessment of airway anatomy. During OLV with BBs, we should pay attention to balloon malposition to prevent cardiopulmonary crises.
摘要：
背景：双腔管（DLT）和支气管阻滞剂（BBs）可用于建立胸外科手术的单肺通气（OLV）。当DLT不适合或患者气道困难时，BB是一个很好的选择。然而,BB更容易错位，导致不良事件。
方法：我们介绍了一名68岁的男性患者，该患者计划进行胸腔镜左下肺叶切除术。患者术前预期不会有气道畸形。当全身麻醉诱导后DLT不能插入支气管时，我们用BB来执行OLV.手术期间,BB的错位导致了“不完整的气球瓣膜”的发展，导致心肺危机.
结论：胸部手术前，必须先进行胸部计算机断层扫描扫描，以评估气道解剖结构。气道的三维重建可以提供更直观的气道解剖评估。在使用BB的OLV期间，我们应该注意气球错位，以防止心肺危机。
方法：我们介绍了一名68岁的男性患者，该患者计划进行胸腔镜左下肺叶切除术。患者术前预期不会有气道畸形。当全身麻醉诱导后DLT不能插入支气管时，我们用BB来执行OLV.手术期间,BB的错位导致了“不完整的气球瓣膜”的发展，导致心肺危机.
结论：胸部手术前，必须先进行胸部计算机断层扫描扫描，以评估气道解剖结构。气道的三维重建可以提供更直观的气道解剖评估。在使用BB的OLV期间，我们应该注意气球错位，以防止心肺危机。
