Improving Lung Deflation With Bronchial Blockers

Bronchial blockers allow us to perform lung isolation using a single lumen endotracheal tube. Compared to double-lumen tubes (DLTs) which are considered the gold standard for lung isolation and allow each lumen to be suctioned independently, bronchial blockers are often quite finicky as they migrate and make it difficult to deflate the operative lung completely.

EZ blocker

After placing a single lumen endotracheal tube (ETT), I’ll intentionally use 100% oxygen or a high concentration of nitrous oxide prior to confirming my bronchial blocker’s placement with bronchoscopy and ultimately performing lung isolation. After I inflate the relevant cuff, the portion(s) of lung which were filled with either pure oxygen or nitrous oxide should collapse fairly quickly due to the effects of absorption atelectasis and faster uptake of nitrous oxide in the nonventilated lung due to pressure gradients, respectively.

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