Endoscopic removal of a bronchial carcinoma in a dog using one-lung ventilation

Abstract

Objective To describe anesthetic management of endoscopic electrosurgical removal of a bronchial carcinoma, partially blocking the right main stem bronchus in a Cocker Spaniel. Study Design Clinical case report. Animals Dog with a bronchial carcinoma. Methods To allow sufficient space for the endoscope and to avoid an oxygen-rich gas mixture in the trachea, which carries the risk of an airway fire when electrocautery is used, a 1 lumen endobronchial tube (EBT) was inserted into the left main stem bronchus. One-lung ventilation (OLV) started with a volume-controlled ventilator was switched to pressure-controlled ventilation in combination with positive end-expiratory pressure (PEEP). Results Resection of the bronchial carcinoma was successful. The dog was hypercapnic throughout the procedure and a high alveolar-arterial oxygen gradient was measured. Conclusion An EBT may be a feasible and safe option to provide OLV for bronchoscopic electrocautery with a closed thoracic cavity in dogs. Clinical Relevance EBT intubation for OLV should be considered as part of the anesthetic management of airway diseases treated with bronchoscopic electrocautery. © Copyright 2008 by The American College of Veterinary Surgeons.