Articles: bronchial-blocker.
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J. Cardiothorac. Vasc. Anesth. · Aug 2014
Airway Ventilation Pressures During Bronchoscopy, Bronchial Blocker, and Double-Lumen Endotracheal Tube Use: An In Vitro Study.
To quantify inspiratory flow resistance of instrumented single-lumen and double-lumen endotracheal tubes. ⋯ Pressure loss across instrumented endotracheal tubes follows a predictable flow-dependant quadratic pattern. Using the quantitative in vitro results of this study, a clinician can maximize inspiratory ventilation pressures during these situations without delivering excessive airway pressures to the patient.
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J. Cardiothorac. Vasc. Anesth. · Aug 2014
Randomized Controlled TrialDisconnection Technique with a Bronchial Blocker for Improving Lung Deflation: A Comparison with a Double-Lumen Tube and Bronchial Blocker Without Disconnection.
One-lung ventilation (OLV) is accomplished with a double-lumen tube (DLT) or a bronchial blocker (BB). The authors compared the effectiveness of lung collapse using DLT, BB, and BB with the disconnection technique. ⋯ A BB with spontaneous collapse took longer to deflate and did not provide equivalent surgical exposure to the DLT. The disconnection technique could be helpful to accelerate lung collapse with a BB.
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The development and evolution of the endotracheal tube (ETT) have been closely related to advances in surgery and anesthesia. Modifications were made to accomplish many tasks, including minimizing gross aspiration, isolating a lung, providing a clear facial surgical field during general anesthesia, monitoring laryngeal nerve damage during surgery, preventing airway fires during laser surgery, and administering medications. In critical care management, ventilator-associated pneumonia (VAP) is a major concern, as it is associated with increased morbidity, mortality, and cost. ⋯ Modifications to the ETT that attempt to prevent bacteria from entering around the ETT include maintaining an adequate cuff pressure against the tracheal wall, changing the material and shape of the cuff, and aspirating the secretions that sit above the cuff. Attempts to reduce bacterial entry through the tube include antimicrobial coating of the ETT and mechanically scraping the biofilm from within the ETT. Studies evaluating the effectiveness of these modifications and techniques demonstrate mixed results, and clear recommendations for which modification should be implemented are weak.
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The administration of test substances into a single lung, or lung lobe, allows the remaining untreated lung to act as an experimental control and effectively halves the number of animals required in a given experiment. It reduces the likelihood of early fatal pulmonary failure when noxious substances are studied which may lessen the need for replacement animals. ⋯ The advantages of using minipigs; ease of handling, reduced housing requirements, genetic homogeneity, etc. are reduced if their diminutive size makes lung studies difficult. This article describes the use of a bronchial blocking device and a sheathed bronchoscope which enabled sterile endobronchial substance administration in Göttingen minipigs, and allowed pulmonary aspiration studies to be conducted with each animal acting as its own control.