Application Of Arndt Bronchial Blocker In Single Lung Ventilation During Thoracic Surgery

Application of Arndt bronchial blocker in single lung ventilation during thoracic surgeryPurposesThe present study was designed to seek the feasibility of Arndt bronchial blocker for single lung ventilation during thoracic surgical procedures, and to evaluate the correlation between the patients' height, chest circumference and the depth of Arndt bronchial blocker in the bronchi and the volume of the capsule of Arndt bronchial blocker, as well as to find the possibility of introducing the Arndt bronchial blocker without the assistance of optical fibro-bronchoscope.Methods42 cases with thoracic surgical procedures were included in the study. After identifying the height and chest circumference, the patients were anesthesitized using the rapid sequence induction technique and intubated. The Arndt bronchial blocker was introduced into either left or right main bronchi with or without fibro-optical bronchoscope (FOB). The capsule of Arndt bronchial blocker was inflated in order to block the bronchi and the single lung ventilation was exercised. The depth of Arndt bronchial blocker (distance between the teeth and the tip of the Arndt bronchial blocker), the volume of the inflated capsule were recorded. The correlation between the patients' height, chest circumference and the depth of the Arndt bronchial blocker in the bronchi and the volume of the capsule of the Arndt bronchial blocker was analysed logistic regression.ResultsAll the procedures were completed successfully with single lung ventilation supplied with Arndt bronchial blockers. No correlation was found between the depth of Arndt bronchial blocker and the height of the patients, as well as the volume of inflated capsule and the chest circumference of the patients. However, the volume of inflated capsule in the left and right main bronchi was different, 4.25±0.70 (3-6)ml and 4.95±0.55(4.0-6.5)ml, respectively. The Arndt bronchial blocker was easily introduced into the right main bronchi (5/5 cases) and failed in 2 out of 5 cases in the left main bronchi without the assistance of FOB.ConclusionsArndt bronchial blockers can be safely used for single lung ventilation. There was no correlation between the patients' height and the depth of the Arndt bronchial blockers as well as the chest circumference and the inflated volume of the capsule of the Arndt bronchial blockers. However, the inflated volume of the capsule of the Arndt bronchial blockers was different in left and right main bronchi. There is possibility of introducing the Arndt bronchial blockers into the right main bronchi without assistance of FOB and the feasibility of Arndt bronchial blockers into left main bronchi remains uncertain.