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George A Arndt - One of the best experts on this subject based on the ideXlab platform.

  • Single-lung ventilation in a pediatric patient using a pediatric fibreoptically-directed wire-guided Endobronchial Blocker
    Canadian Journal of Anesthesia, 2002
    Co-Authors: Asta Saulys, Peter M Popic, George A Arndt
    Abstract:

    Purpose The pediatric wire-guided Endobronchial Blocker is a new device for single-lung ventilation through small diameter endotracheal tubes. In this case report we will discuss the use of this Blocker in a pediatric patient. Clinical features We successfully placed the pediatric wire-guided Endobronchial Blocker in a 14-yr-old patient who underwent an aortic coarctation repair. The Blocker is a 5-French 70 cm double-lumen catheter. One lumen contains an adjustable wire loop. The other lumen inflates a spherical low pressure, high volume balloon. Through a special bronchoscopy port, the Blocker and bronchoscope were placed into a 7.0 cuffed endotracheal tube, the bronchoscope passed through the wire loop of the Blocker and advanced towards the left mainstem bronchus. Then the Blocker was advanced over the bronchoscope and positioned in the left mainstem bronchus. The balloon was slowly inflated under direct vision and the bronchoscope removed. During the case, single lung ventilation was achieved by inflating the balloon, thus collapsing the lung. At the end of the case, the lung was reinflated by deflating the balloon and the Blocker was removed without difficulty. The patient tolerated the procedure well and had an uneventful postoperative course. Conclusion Because of the Endobronchial Blocker’s small diameter, this device can be used in a small endotracheal tube without sacrificing the inner diameter (ID) cross sectional area. Therefore, the patient is ventilated through a conventional endotracheal tube with a larger ID compared to the ID of a double-lumen endotracheal tube. Objectif Le bloqueur endobronchique avec guide métallique est un nouveau dispositif de ventilation unilatérale au travers d’un tube endotrachéal de petit diamètre. Nous discutons de l’usage de ce bloqueur chez un enfant. Éléments cliniques Nous avons réussi à insérer un bloqueur endobronchique pédiatrique avec guide métallique chez un patient de 14 ans qui devait subir la réparation d’une coarctation de l’aorte. Le bloqueur est un cathéter 5-French, de 70 cm, à double lumière dont l’une contient la boucle métallique ajustable et l’autre permet de gonfler un ballonnet de haut volume et basse pression. Par un connecteur bronchoscopique spécial, le bloqueur et le bronchoscope ont été placés dans un tube endotrachéal à ballonnet no 7,0, le bronchoscope passant au travers de la boucle métallique du bloqueur et s’avançant dans la bronche principale gauche. Puis, le bloqueur a été glissé pardessus le bronchoscope et mis en place dans la bronche principale gauche. Le ballonnet est alors gonflé lentement sous vision directe et le bronchoscope enlevé. Pendant l’opération, la ventilation unilatérale est assurée en gonflant le ballonnet et en affaissant le poumon. À la fin de l’intervention, le poumon est gonflé de nouveau par le dégonflement du ballonnet et le bloqueur est enlevé sans difficulté. Le patient a bien toléré l’intervention et aucun incident postopératoire n’est survenu. Conclusion Étant donné le petit diamètre du bloqueur endobronchique, ce dispositif peut être utilisé dans un petit tube endotrachéal sans sacrifier la surface de la section transversale du diamètre interne (DI). Ainsi, le patient reçoit une ventilation traditionnelle par le tube endotrachéal à large DI comparé au DI du tube endotrachéal à double lumière.

  • Wire-guided Endobronchial Blockade: An Alternative Means For Achieving One-lung Ventilation
    The Internet Journal of Emergency and Intensive Care Medicine, 1999
    Co-Authors: George A Arndt
    Abstract:

    The goal of this presentation is to introduce a new method of one-lung ventilation using a wire guided Endobronchial Blocker. Ten key points in using this device are described.

  • one lung ventilation when intubation is difficult presentation of a new Endobronchial Blocker
    Acta Anaesthesiologica Scandinavica, 1999
    Co-Authors: George A Arndt, S T Delessio, Paul W Kranner, W Orzepowski, B Ceranski, B Valtysson
    Abstract:

    Background: One-lung ventilation utilizing a double-lumen endotracheal tube may be technically difficult or inappropriate in morbidly obese or critically ill patients. In patients requiring awake fiberoptic intubation, double-lumen tube placement may be impossible. Wire-guided Endobronchial blockade through a conventional endotracheal tube is a new alternative for these patients. Methods: A 44-year-old, 133 kg female patient was scheduled to undergo a thoracotomy for transthoracic fundoplication. A wire-guided Endobronchial Blocker (WEB) was placed following rapid-sequence induction and intubation with an 8.0 OD single-lumen endotracheal tube with the aid of a pediatric bronchoscope. Results: The WEB, using a guiding loop, was placed with ease and allowed effective one-lung ventilation. Conclusion: The WEB system allows one-lung ventilation to be achieved with a conventional endotracheal tube. The need for reintubation at the end of surgery is eliminated and endotracheal tube cross-sectional area is conserved.

Minwen Yang - One of the best experts on this subject based on the ideXlab platform.

  • use of the arndt wire guided Endobronchial Blocker via nasal for one lung ventilation in patient with anticipated restricted mouth opening for esophagectomy
    European Journal of Cardio-Thoracic Surgery, 2005
    Co-Authors: Cheeyueh Angie Ho, Chunyu Chen, Minwen Yang
    Abstract:

    Functional separation of the lungs may be accomplished by several methods. Patient with restricted mouth opening has limited options for one-lung ventilation. We report the use of wire-guided Endobronchial blockade, a new tool for achieving one-lung ventilation in a patient with restricted mouth opening requiring nasotracheal, fiberoptic intubation for esophagectomy and reconstruction with gastric tube substitution. Q 2005 Elsevier B.V. All rights reserved.

  • use of the arndt wire guided Endobronchial Blocker to facilitate one lung ventilation for pediatric empyema during video assisted thoracoscopy
    Chang Gung medical journal, 2005
    Co-Authors: Angie C Y Ho, Chunyu Chen, Minwen Yang
    Abstract:

    BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has emerged as an innovative and popular procedure for the management of postpneumonic empyema in children refractory to a medical response. One-lung ventilation is required during VATS. In this study, we evaluated the efficacy of intraoperative wire-guided Endobronchial blockade (WEB) for achieving 1-lung ventilation during a thoracoscopic procedure for pediatric empyema. METHODS: Eighteen patients undergoing a VATS approach for evacuation of an empyema cavity were studied. We used a new device, a bronchial Blocker tube, to establish 1-lung ventilation. Intraoperative oxygenation, ventilation, and hemodynamics, as well as the duration of the operation during 1-lung ventilation were recorded. The number of unsuccessful placement attempts, number of malpositionings of the device, and the number of secondary dislodgements of the device after turning the patient into the lateral position were also counted. The quality of lung deflation and inflation was rated by the surgeon under direct visualization as either excellent, fair, or poor. RESULTS: The mean operative time was 80+/-10.8 (range, 50 approximately 120) min. The mean peak inspiratory pressure under 1-lung ventilation was 28.7+/-3.6 cm H2O, and no desaturation was noted. A number of unsuccessful placement attempts were required in 1 patient (1/18) for left-sided VATS. No malpositioning or secondary dislodgement of the device was noted. The quality of lung deflation was judged as being excellent in all patients. CONCLUSIONS: VATS can safely and effectively be performed in children with a proper anesthetic technique. With the development and clinical use of this new device, the bronchial Blocker tube proved to be effective and easy to use for establishing 1-lung ventilation in a pediatric population.

George Arndt - One of the best experts on this subject based on the ideXlab platform.

Asta Saulys - One of the best experts on this subject based on the ideXlab platform.

  • single lung ventilation in a pediatric patient using a pediatric fibreoptically directed wire guided Endobronchial Blocker
    Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2002
    Co-Authors: Asta Saulys, Peter M Popic, George Arndt
    Abstract:

    Purpose The pediatric wire-guided Endobronchial Blocker is a new device for single-lung ventilation through small diameter endotracheal tubes. In this case report we will discuss the use of this Blocker in a pediatric patient.

  • Single-lung ventilation in a pediatric patient using a pediatric fibreoptically-directed wire-guided Endobronchial Blocker
    Canadian Journal of Anesthesia, 2002
    Co-Authors: Asta Saulys, Peter M Popic, George A Arndt
    Abstract:

    Purpose The pediatric wire-guided Endobronchial Blocker is a new device for single-lung ventilation through small diameter endotracheal tubes. In this case report we will discuss the use of this Blocker in a pediatric patient. Clinical features We successfully placed the pediatric wire-guided Endobronchial Blocker in a 14-yr-old patient who underwent an aortic coarctation repair. The Blocker is a 5-French 70 cm double-lumen catheter. One lumen contains an adjustable wire loop. The other lumen inflates a spherical low pressure, high volume balloon. Through a special bronchoscopy port, the Blocker and bronchoscope were placed into a 7.0 cuffed endotracheal tube, the bronchoscope passed through the wire loop of the Blocker and advanced towards the left mainstem bronchus. Then the Blocker was advanced over the bronchoscope and positioned in the left mainstem bronchus. The balloon was slowly inflated under direct vision and the bronchoscope removed. During the case, single lung ventilation was achieved by inflating the balloon, thus collapsing the lung. At the end of the case, the lung was reinflated by deflating the balloon and the Blocker was removed without difficulty. The patient tolerated the procedure well and had an uneventful postoperative course. Conclusion Because of the Endobronchial Blocker’s small diameter, this device can be used in a small endotracheal tube without sacrificing the inner diameter (ID) cross sectional area. Therefore, the patient is ventilated through a conventional endotracheal tube with a larger ID compared to the ID of a double-lumen endotracheal tube. Objectif Le bloqueur endobronchique avec guide métallique est un nouveau dispositif de ventilation unilatérale au travers d’un tube endotrachéal de petit diamètre. Nous discutons de l’usage de ce bloqueur chez un enfant. Éléments cliniques Nous avons réussi à insérer un bloqueur endobronchique pédiatrique avec guide métallique chez un patient de 14 ans qui devait subir la réparation d’une coarctation de l’aorte. Le bloqueur est un cathéter 5-French, de 70 cm, à double lumière dont l’une contient la boucle métallique ajustable et l’autre permet de gonfler un ballonnet de haut volume et basse pression. Par un connecteur bronchoscopique spécial, le bloqueur et le bronchoscope ont été placés dans un tube endotrachéal à ballonnet no 7,0, le bronchoscope passant au travers de la boucle métallique du bloqueur et s’avançant dans la bronche principale gauche. Puis, le bloqueur a été glissé pardessus le bronchoscope et mis en place dans la bronche principale gauche. Le ballonnet est alors gonflé lentement sous vision directe et le bronchoscope enlevé. Pendant l’opération, la ventilation unilatérale est assurée en gonflant le ballonnet et en affaissant le poumon. À la fin de l’intervention, le poumon est gonflé de nouveau par le dégonflement du ballonnet et le bloqueur est enlevé sans difficulté. Le patient a bien toléré l’intervention et aucun incident postopératoire n’est survenu. Conclusion Étant donné le petit diamètre du bloqueur endobronchique, ce dispositif peut être utilisé dans un petit tube endotrachéal sans sacrifier la surface de la section transversale du diamètre interne (DI). Ainsi, le patient reçoit une ventilation traditionnelle par le tube endotrachéal à large DI comparé au DI du tube endotrachéal à double lumière.

R K Horber - One of the best experts on this subject based on the ideXlab platform.

  • fluoroscopic guidance of arndt Endobronchial Blocker placement for single lung ventilation in small children
    Acta Anaesthesiologica Scandinavica, 2008
    Co-Authors: Bruno Marciniak, Pierre Fayoux, Anne Hebrard, Thomas Engelhardt, C Weinachter, R K Horber
    Abstract:

    Background: Thoracoscopic surgery may require single-lung ventilation (SLV) in infants and small children. A variety of balloon-tipped Endobronchial Blockers exist but the placement is technically challenging if the size of the tracheal tube does not allow the simultaneous passage of the fibreoptic scope and the Endobronchial Blocker. This report describes a technique for Endobronchial Blocker insertion using fluoroscopic guidance in children undergoing SLV. Methods: After approval from the local Medical Ethics Committee and parental consent, 18 patients aged 2 years or younger scheduled for thoracic surgery requiring SLV were prospectively included. Following induction of anesthesia, a 5 Fr Endobronchial Blocker (Cook® Arndt Endobronchial Blocker) was inserted first into the trachea under direct laryngoscopy. Correct placement in the main bronchus was assessed by fluoroscopy and tracheal intubation next to the Endobronchial Blocker. Optimal position and balloon inflation was verified using a fibreoptic scope. The duration and number of insertion attempts as well as age, weight and size of the tracheal tube were recorded. Results: Eighteen patients were studied. Median (range) age and weight were 12 (0.2–24) months and 11.2 (4–15) kg, respectively. SLV was successfully achieved in all patients using a 5 Fr Endobronchial Blocker outside a 3.5–4.5 mm ID tracheal tube within 11.2 (±2.2) min. No side effects were observed during the procedure. Conclusion: Fluoroscopic-guided insertion of extraluminal Endobronchial Blocker is an effective and reliable tool to place Arndt Endobronchial Blockers in small children.

  • Fluoroscopic guidance of Arndt Endobronchial Blocker placement for single‐lung ventilation in small children
    Acta Anaesthesiologica Scandinavica, 2008
    Co-Authors: Bruno Marciniak, Pierre Fayoux, Anne Hebrard, Thomas Engelhardt, C Weinachter, R K Horber
    Abstract:

    Background: Thoracoscopic surgery may require single-lung ventilation (SLV) in infants and small children. A variety of balloon-tipped Endobronchial Blockers exist but the placement is technically challenging if the size of the tracheal tube does not allow the simultaneous passage of the fibreoptic scope and the Endobronchial Blocker. This report describes a technique for Endobronchial Blocker insertion using fluoroscopic guidance in children undergoing SLV. Methods: After approval from the local Medical Ethics Committee and parental consent, 18 patients aged 2 years or younger scheduled for thoracic surgery requiring SLV were prospectively included. Following induction of anesthesia, a 5 Fr Endobronchial Blocker (Cook® Arndt Endobronchial Blocker) was inserted first into the trachea under direct laryngoscopy. Correct placement in the main bronchus was assessed by fluoroscopy and tracheal intubation next to the Endobronchial Blocker. Optimal position and balloon inflation was verified using a fibreoptic scope. The duration and number of insertion attempts as well as age, weight and size of the tracheal tube were recorded. Results: Eighteen patients were studied. Median (range) age and weight were 12 (0.2–24) months and 11.2 (4–15) kg, respectively. SLV was successfully achieved in all patients using a 5 Fr Endobronchial Blocker outside a 3.5–4.5 mm ID tracheal tube within 11.2 (±2.2) min. No side effects were observed during the procedure. Conclusion: Fluoroscopic-guided insertion of extraluminal Endobronchial Blocker is an effective and reliable tool to place Arndt Endobronchial Blockers in small children.