One-lung ventilation with a bronchial blocker in thoracic patients
Abstract Background Lung isolation is a technique used in a multitude of surgeries to ensure single-lung ventilation with collapse of the contralateral lung, as to achieve improved access and visualization of relevant anatomical structures. Despite being accepted and having favorable outcomes, bronc...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-023-02362-z |
| _version_ | 1797397799935934464 |
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| author | Paulo Andrés Cano Luis Carlos Mora Irene Enríquez Matías Santiago Reis Eva Martínez Fernando Barturen |
| author_facet | Paulo Andrés Cano Luis Carlos Mora Irene Enríquez Matías Santiago Reis Eva Martínez Fernando Barturen |
| author_sort | Paulo Andrés Cano |
| collection | DOAJ |
| description | Abstract Background Lung isolation is a technique used in a multitude of surgeries to ensure single-lung ventilation with collapse of the contralateral lung, as to achieve improved access and visualization of relevant anatomical structures. Despite being accepted and having favorable outcomes, bronchial blockers (BBs) are not to this day the main device of choice among anaesthesiologists. Methods In this retrospective and descriptive study, we analyzed the safety and efficacy of a BB in all types of thoracic surgeries in our centre between 2015 and 2022, excluding patients with massive hemoptysis or empyema, or who had undergone a prior pneumonectomy. Results One hundred and thirty-four patients were intervened due to lung cancer (67.9%), respiratory disease (23.9%), and non-respiratory disease (8.2%) undergoing lung surgeries (65.7%), pleural and mediastinal surgeries (29.9%), chest wall surgeries (3.0%) and other surgeries (1.5%). In most cases, lung collapse was considered excellent (63.9%) or good (33.1%) with only 4 cases (3.0%) of poor lung collapse. More than 90% of patients did not present intraoperative or immediate postoperative complications. No statistically significant differences were found between lung collapse and the demographic, clinical or BB-related variables (p > 0.05). However, we found a significatively higher proportion of excellent lung collapses in VATS surgeries and lateral decubitus positioning, as well as a significatively less proportion of poor lung collapses (p < 0.05). Moreover, there was a significantly higher proportion of excellent lung collapses when the BB was placed in the left bronchus (p < 0.05). Conclusions With these results, in our experience BBs constitute an effective alternative, capable of achieving pulmonary collapse in all kinds of thoracic procedures with satisfactory safety rates due to their minimal complications. |
| first_indexed | 2024-03-09T01:15:25Z |
| format | Article |
| id | doaj.art-2be6679b549246b083201b762aee2841 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-09T01:15:25Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-2be6679b549246b083201b762aee28412023-12-10T12:29:22ZengBMCBMC Anesthesiology1471-22532023-12-012311710.1186/s12871-023-02362-zOne-lung ventilation with a bronchial blocker in thoracic patientsPaulo Andrés Cano0Luis Carlos Mora1Irene Enríquez2Matías Santiago Reis3Eva Martínez4Fernando Barturen5Department of Anaesthesiology and Resuscitation, Hospital Universitario Son EspasesDepartment of Anaesthesiology and Resuscitation, Hospital Universitario Son EspasesDepartment of Anaesthesiology and Resuscitation, Hospital Universitario Son EspasesDepartment of Anaesthesiology and Resuscitation, Hospital Universitario Son EspasesDepartment of Anaesthesiology and Resuscitation, Hospital Universitario Son EspasesDepartment of Anaesthesiology and Resuscitation, Hospital Universitario Son EspasesAbstract Background Lung isolation is a technique used in a multitude of surgeries to ensure single-lung ventilation with collapse of the contralateral lung, as to achieve improved access and visualization of relevant anatomical structures. Despite being accepted and having favorable outcomes, bronchial blockers (BBs) are not to this day the main device of choice among anaesthesiologists. Methods In this retrospective and descriptive study, we analyzed the safety and efficacy of a BB in all types of thoracic surgeries in our centre between 2015 and 2022, excluding patients with massive hemoptysis or empyema, or who had undergone a prior pneumonectomy. Results One hundred and thirty-four patients were intervened due to lung cancer (67.9%), respiratory disease (23.9%), and non-respiratory disease (8.2%) undergoing lung surgeries (65.7%), pleural and mediastinal surgeries (29.9%), chest wall surgeries (3.0%) and other surgeries (1.5%). In most cases, lung collapse was considered excellent (63.9%) or good (33.1%) with only 4 cases (3.0%) of poor lung collapse. More than 90% of patients did not present intraoperative or immediate postoperative complications. No statistically significant differences were found between lung collapse and the demographic, clinical or BB-related variables (p > 0.05). However, we found a significatively higher proportion of excellent lung collapses in VATS surgeries and lateral decubitus positioning, as well as a significatively less proportion of poor lung collapses (p < 0.05). Moreover, there was a significantly higher proportion of excellent lung collapses when the BB was placed in the left bronchus (p < 0.05). Conclusions With these results, in our experience BBs constitute an effective alternative, capable of achieving pulmonary collapse in all kinds of thoracic procedures with satisfactory safety rates due to their minimal complications.https://doi.org/10.1186/s12871-023-02362-zBronchial blockerLung collapseSingle-lung ventilationThoracic Surgery |
| spellingShingle | Paulo Andrés Cano Luis Carlos Mora Irene Enríquez Matías Santiago Reis Eva Martínez Fernando Barturen One-lung ventilation with a bronchial blocker in thoracic patients BMC Anesthesiology Bronchial blocker Lung collapse Single-lung ventilation Thoracic Surgery |
| title | One-lung ventilation with a bronchial blocker in thoracic patients |
| title_full | One-lung ventilation with a bronchial blocker in thoracic patients |
| title_fullStr | One-lung ventilation with a bronchial blocker in thoracic patients |
| title_full_unstemmed | One-lung ventilation with a bronchial blocker in thoracic patients |
| title_short | One-lung ventilation with a bronchial blocker in thoracic patients |
| title_sort | one lung ventilation with a bronchial blocker in thoracic patients |
| topic | Bronchial blocker Lung collapse Single-lung ventilation Thoracic Surgery |
| url | https://doi.org/10.1186/s12871-023-02362-z |
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