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Anesth Analg 2003;96:1239
© 2003 International Anesthesia Research Society

LETTERS TO THE EDITOR

Possible Right Lung Isolation By Blocking the Tracheal Bronchus with only a Univent Tube for Some Patients

Hirokatsu Toyoyama, MD, Wakaba Minami, MD, and Yoshiro Toyoda, MD

Department of Anesthesia, Osaka Kosei-Nenkin Hospital, Osaka, Japan

To the Editor:

Dr. Shyr does not wish to respond.

We read with great interest the article by Lee et al. (1). We fully subscribe to the efficacy of one-lung ventilation by combining a Fogarty catheter with a Univent tube to block the tracheal bronchus of your patient. However, we have some concerns regarding blocking of a tracheal bronchus with a Fogarty catheter.

The distance between the tracheal bronchus and the tracheal carina is not mentioned. When an ectopic tracheal bronchus is located high enough above the carina, the end of a Univent tube can be put near and above the carina to block the tracheal bronchus with the tracheal cuff of the Univent tube, while the right mainstem bronchus can be blocked with a Univent bronchial blocker. If this can be done and the left lung can be ventilated adequately, a Fogarty catheter may not be needed in addition to a Univent tube for obstructing the right lung with a tracheal bronchus.

In conclusion, we believe that the right lung can only be isolated with a Univent tube for some patients with a tracheal bronchus located high enough above the carina.

Reference

  1. Lee HL, Pelosi F, Ho Angie CY, Cheng Robin KS. Successful one-lung ventilation in a patient with aberrant tracheal bronchus. Anesth Analg 2002; 95: 492–3.[Abstract/Free Full Text]




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press