you need to disconnect ventilation before isolation and surgerical incision right? Because if you isolate one side without disconnecting the ventilation..........the lung is not collapsed
Hi, I was doing a lung case with a E-Z blocker.. After the OLV in progress...all of a sudden the ETCO2 tracing went flat and I could nt ambue. I met a lot of resistance. Sats were in the high 90s but remained stable. What happened in the lung to create this event? Thank you!
Interesting! My first guess would be the blocker slipping back a bit and thus obstructing the trachea. Sometimes if one overinflates the balloon, it will "herniate" over the carina and give this problem. One can maintain oxygenation with small ventilation volumes, but the resistance to flow is high and lack of adequate Vt leads to little or no EtCO2 trace.
This was demonstrated with either a 3.2 or 3.5 mm fiberoptic bronchoscope - forgive me if I can't recall which! One needs a "paediatric" (4.0 mm or less) bronchoscope, but it is ideal if it has a working channel so that you can suck out any secretions or soiling if encountered.
you need to disconnect ventilation before isolation and surgerical incision right? Because if you isolate one side without disconnecting the ventilation..........the lung is not collapsed
thank you !
Thank you🌿
Hi, I was doing a lung case with a E-Z blocker.. After the OLV in progress...all of a sudden the ETCO2 tracing went flat and I could nt ambue. I met a lot of resistance. Sats were in the high 90s but remained stable. What happened in the lung to create this event? Thank you!
Did you recheck with a bronchoscope?
Interesting! My first guess would be the blocker slipping back a bit and thus obstructing the trachea. Sometimes if one overinflates the balloon, it will "herniate" over the carina and give this problem. One can maintain oxygenation with small ventilation volumes, but the resistance to flow is high and lack of adequate Vt leads to little or no EtCO2 trace.
What size bronchoscope were you using?
This was demonstrated with either a 3.2 or 3.5 mm fiberoptic bronchoscope - forgive me if I can't recall which! One needs a "paediatric" (4.0 mm or less) bronchoscope, but it is ideal if it has a working channel so that you can suck out any secretions or soiling if encountered.
Fantastic
Thanks Mohamed! Please let us know if you have suggestions for other videos and future content you would like to see.
Great video.
What is the outer diameter of EZ Blocker?
The shaft of a EZ-Blocker is 7 French, so 2.33 mm
Thanks !!