Update on tracheobronchial anatomy and flexible fiberoptic bronchoscopy in thoracic anesthesia

Abstract

Purpose of review This review is focused on tracheobronchial anatomy and the use of flexible fiberoptic bronchoscopy in thoracic anesthesia. Recent findings A complete knowledge of tracheobronchial anatomy is a key factor in determining proper position of lung isolation devices, namely double-lumen endotracheal tubes and bronchial blockers. In addition, changes occur in tracheobronchial anatomy with age; therefore, it is very important that every anesthesiologist is familiar with these anatomical changes in order to recognize anatomical landmarks and perform a successful placement of lung isolation devices. Flexible fiberoptic bronchoscopy must be considered an art in the practice of thoracic anesthesia. Summary Recognition of tracheobronchial anatomy and familiarity with the use of flexible fiberoptic bronchoscope are key components while managing patients undergoing thoracic surgery and anesthesia. © 2009 Wolters Kluwer Health|Lippincott Williams & Wilkins.