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Difficult Airway Management in Thoracic Surgery

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Anesthesia in Thoracic Surgery

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Abstract

It is estimated that between 5% and 8% of patients with primary lung carcinoma also have a carcinoma of the pharynx and many of these patients have undergone radiation to the neck and/or extensive surgery on the upper airway and the neck. Also, a patient who requires OLV might have distorted anatomy at or beyond the tracheal carina that makes the insertion of a left-sided DLT relatively difficult or impossible.

The safest way to establish an airway is by securing the airway with a single-lumen endotracheal tube placed orally or nasotracheally with the aid of flexible fiber-optic bronchoscopy. Lung isolation in these patients is achieved best with the use of an independent bronchial blocker. An alternative can be the use of a DLT with an airway exchange technique when there is an absolute indication for lung separation. For the patient who has a tracheostomy in place, the use of an independent bronchial blocker through a single-lumen endotracheal tube or through a Shiley tracheostomy cannula in place is recommended. For all these devices, a flexible fiber-optic bronchoscopy examination is recommended prior, during placement and at the conclusion of the use of lung isolation device.

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Author information

Authors and Affiliations

  1. University of Iowa Health Care, Iowa City, IA, USA

    Javier H. Campos

  2. Section of Anesthesiology, Hospital General Universitario de Valencia, Valencia, Spain

    Manuel Granell Gil

  3. University of Valencia, Valencia, Spain

    Manuel Granell Gil

Authors
  1. Javier H. Campos
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  2. Manuel Granell Gil
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Corresponding author

Correspondence to Javier H. Campos .

Editor information

Editors and Affiliations

  1. Consorcio Hospital General Universitario, Valencia, Spain

    Manuel Granell Gil

  2. Istanbul Medical Faculty, Department of Anaesthesiology, Istanbul University, Istanbul, Turkey

    Mert Şentürk

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Campos, J.H., Granell Gil, M. (2020). Difficult Airway Management in Thoracic Surgery. In: Granell Gil, M., Şentürk, M. (eds) Anesthesia in Thoracic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-28528-9_9

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  • DOI: https://doi.org/10.1007/978-3-030-28528-9_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-28527-2

  • Online ISBN: 978-3-030-28528-9

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