Gelecek Bronşiyal Blokerlerin mi
2014
Does the Future Belong to Bronchial Blockers?Lung isolation is widely used in many areas, mainly in thoracic surgical operations. Double-lumen tubes and bronchial blockers are utilized for this purpose.The first tube used for lung isolation is Carlens and many double-lumen tubes have been developed so far. The first example of a bronchial blocker in the modern sense is the Univent tube and independent bronchial blockers (Arndt, Cohen, Uniblocker, EZ, Coopdech, etc.) have been developed in the more recent years. Double-lumen tubes require less time to place and have a lower tendency to malpositioning as compared to bronchial blockers. Aspiration is more effective with double-lumen tubes, and a single lung or both lungs may be ventilated as required. While double-lumen tubes have these advantages, bronchial blockers are recommended as the first option in patients with a challenging airway; in obese patients; in patients in whom mechanical ventilation is predicted during the postoperative period; in patients who require lung isolation during any intraoperative period; and in children. This review discusses the development of equipment used for lung isolation, their advantages and disadvantages over each other, and their priority of use. Indeed, the thoracic anesthesiologist should be knowledgeable and experienced enough to be able to use both types of lung isolation equipment as required.
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