Lung Isolation

Abstract

During the preoperative period, review of the posteroanterior chest radiograph is necessary to measure the tracheal width and also appreciate the pattern of the tracheobronchial anatomy to determine what device and size to use. The left-sided DLT is the most common device used for lung isolation because of its greater margin of safety. The use of bronchial blockers is indicated in patients who present with difficult airways and require lung isolation. Patients with a tracheostomy in place requiring lung isolation are best managed with the use of an independent bronchial blocker and flexible fiberoptic bronchoscopy. Flexible fiberoptic bronchoscopy is the recommended method to achieve optimal position of lung isolation devices, first in supine position, later in lateral decubitus, or whenever a malposition occurs.