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Correspondence  |   July 2003
Alternative Method to Deflate the Operated Lung when Using Wire-guided Endobronchial Blockade
Author Notes
  • Zentralklinik Bad Berka, Bad Berka, Germany.
Article Information
Correspondence
Correspondence   |   July 2003
Alternative Method to Deflate the Operated Lung when Using Wire-guided Endobronchial Blockade
Anesthesiology 7 2003, Vol.99, 239-240. doi:
Anesthesiology 7 2003, Vol.99, 239-240. doi:
To the Editor:—
In his excellent review, Dr. Campos 1 describes clinically relevant lung isolation methods. To deflate the lung when using a wire-guided endobronchial blocker (WEB®; Cook, Bloomington, IN), Dr. Campos proposes withdrawing the loop wire, thus opening a 1.4-mm air channel to the atmosphere. Because the procedure as proposed can be very time-consuming, we use an alternative method to deflate the operated lung when using WEB®: After conventional intubation, we introduce the WEB® catheter in the main stem bronchus of the operated lung but do not inflate it. After patient positioning and thoracotomy, we check and, when needed, correct the position of the WEB® catheter using a fiberscope. To deflate the lung, we then disconnect the ventilator from side port of the WEB® connector and thus open the main airway to the atmosphere. After verifying lung collapse, we inflate the WEB® under fiberoptic control and reconnect the ventilator to the endotracheal tube. This way we avoid removing the flexible wire loop, which is essential for repositioning the WEB® if it dislodges during the operation. Only if the surgical field is in close proximity to With regard to this letter and the subsequent two letters and reply, Richard B. Weiskopf, M.D., is the Editor for this exchange. the WEB® balloon do we recommend removing the wire loop during the operation. For most operative procedures, the probability that the WEB® wire loop could be included in the stapling line is very small. Of note, it is essential to inflate the WEB® balloon under fiberoptic control because the amount of air need to properly seal the airway may be otherwise mostly underestimated but occasionally overestimated.
Reference
Reference
Campos JH: Current techniques for perioperative lung isolation in adults. A nesthesiology 2002; 97: 1925–301Campos, JH