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A A Case Rep. 2013 Oct 15;1(2):37-8. doi: 10.1097/ACC.0b013e31829459e6.

Failure of lung isolation by a double-lumen endotracheal tube rescued by the concomitant use of an arndt bronchial blocker under direct visualization.

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  • 1From the *Department of Anesthesiology, Thomas Jefferson University, Philadelphia; and ‚ĆDepartment of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.


Failure of a double-lumen endotracheal tube (DLT) to isolate the lung during thoracic surgery can have significant consequences. In this report, we examine an approach for rescuing a malpositioned DLT. A 37F left-sided DLT was inserted and its proper position confirmed. After positioning, repeat confirmation of position and the ability to achieve 1-lung ventilation were performed, but inadequate isolation of the lung being operated on was noted after incision. A 7-Fr Arndt bronchial blocker was positioned through the tracheal lumen of the DLT to obtain 1-lung ventilation. This technique can be used to rescue a malfunctioning DLT without the need for extubating and reintubating the trachea.

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