Endobronchial blocker

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An endobronchial blocker (also called bronchial blocker) is a device which can be inserted down a tracheal tube after tracheal intubation so as to block off the right or left main bronchus of the lungs in order to be able to achieve a controlled one sided ventilation of the lungs in thoracic surgery. The lung tissue distal to the obstruction will collapse, thus allowing the surgeon's view and access to relevant structures within the thoracic cavity.

Bronchial blockers are used to achieve lung separation and one lung ventilation as an alternative to double-lumen endotrachealtubes (DLT) and are the method of choice in children and paediatric patients for whom even the smallest DLTs might be too big.[1]

Types

Univent tube

Made by Fuji Systems, Tokyo, Japan, is a tracheal tube with a second lumen that contains a coaxial, balloon tipped catheter which can be advanced under fiber optic bronchoscopy and blocked in either bronchus.[1]

Arndt endobronchial blocker

Produced by Cook Critical Care, Bloomington, USA, is a catheter with a balloon tip and inner lumen which contains a flexible wire which is coupled to a fiber optical bronchoscope to guide the device into the desired bronchus.[1]

Cohen endobronchial blocker

By Cook Critical Care, is a catheter shaft with a distal soft nylon flexible tip and balloon which can be deflected by 90° to guide the device into either bronchus.[1]

Coopdech bronchial blocker

By Smith Medical, Rosmalen, NL, has a preformed angulation at the distal tip to aid placement in the desired bronchus.[2][3]

EZ‐blocker

By AnaesthetIQ, Rotterdam, NL , a Y shaped bronchial blocker with two distal extensions to be placed in both main stem bronchi.[4]

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 Brodsky, J. B. (11 December 2009). "Lung separation and the difficult airway". British Journal of Anaesthesia 103 (Supplement 1): i66–i75. doi:10.1093/bja/aep262. 
  2. ↑ Venkataraju, A; Rozario, C; Saravanan, P (April 2010). "Accidental fracture of the tip of the Coopdech bronchial blocker during insertion for one lung ventilation.". Canadian journal of anaesthesia = Journal canadien d'anesthesie 57 (4): 350–4. doi:10.1007/s12630-009-9261-0. PMID 20049575. 
  3. ↑ Ozaki, M; Murashima, K; Koga, K; Sata, T (April 2010). "Use of the Coopdech Bronchial Blocker as a tracheal tube introducer in a patient with difficult laryngoscopy". Journal of anesthesia 24 (2): 319–20. doi:10.1007/s00540-010-0890-9. PMID 20204422. 
  4. ↑ Mourisse, J; Liesveld, J; Verhagen, A; van Rooij, G; van der Heide, S; Schuurbiers-Siebers, O; Van der Heijden, E (March 2013). "Efficiency, efficacy, and safety of EZ-blocker compared with left-sided double-lumen tube for one-lung ventilation". Anesthesiology 118 (3): 550–61. doi:10.1097/ALN.0b013e3182834f2d. PMID 23299364. 
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