Lung isolation techniques - UpToDate 14/9/22, 17:56

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Lung isolation techniques

Authors: Martin Ma, MD, Peter D Slinger, MD, FRCPC
Section Editor: Roberta Hines, MD
Deputy Editor: Nancy A Nussmeier, MD, FAHA

INTRODUCTION

Lung isolation and one lung ventilation (OLV) are routinely used to facilitate surgical
exposure for intrathoracic procedures involving the lungs, esophagus, anterior
mediastinal structures, or aorta, as well as for selected orthopedic spine procedures. Less
commonly, lung isolation may be necessary to prevent soiling of the contralateral lung
when unilateral massive pulmonary hemorrhage or abscess is present, or to avoid
ventilation of a unilateral bronchopleural fistula, lung cyst, or bullae.

This topic will discuss specific devices used for lung isolation (eg, double-lumen
endotracheal tubes or bronchial blockers) and selection of the most appropriate device for
various clinical situations.

The indications, physiology, ventilation strategies, management of hypoxemia, and

complications of OLV are reviewed separately. (See "One lung ventilation: General
principles".)

AIRWAY ANATOMY

Expertise in both laryngoscopy and fiberoptic bronchoscopy (FOB) is necessary to ensure

correct positioning of either a double-lumen endotracheal tube (DLT) or a bronchial
blocker. Details regarding positioning are noted below [1]:

● (See 'Positioning left double-lumen tubes' below.)

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Literature review current through: Aug 2022. | This topic last updated: Aug 09, 2022.

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