REVIEW ARTICLE
Year : 2021  |  Volume : 15  |  Issue : 3  |  Page : 272-279

Lung separation in adult thoracic anesthesia


1 Consulting Anesthesiologist, Service d'Anesthésiologie-Réanimation, C.U.B. Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
2 Chair of the Medical Council, Service d'Anesthésiologie-Réanimation, C.U.B. Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
3 Clinical Director, Past-Chairman and Member of the Thoracic Scientific Subcommittee and Member of the Educational Committee of the European Society of Cardiothoracic Anesthesiologists (EACTA), Service d'Anesthésiologie-Réanimation, C.U.B. Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium

Correspondence Address:
Laszlo L Szegedi
Service d'Anesthésiologie-Réanimation, C.U.B. Hôpital Erasme, Université Libre de Bruxelles (U.L.B.), Route de Lennik 808, 1070 Bruxelles, Brussels
Belgium
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.sja_78_21

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Thoracic anesthesia is mainly the world of OLV during anesthesia. The indications for OLV, classified as absolute or relative are more representative of the new concepts in OLV: It includes either the separation or the isolation of the lungs. Modern DLTs are most widely employed worldwide to perform OLV including the concept of one lung separation. Endobronchial blockers are a valid alternative to DLTs, and they are mandatory in the education of lung separation and in case of predicted difficult airways as they are the safest approach (with an awake intubation with an SLT through a FOB). Every general anesthesiologist should know how to insert a left-sided DLT, but he/she should also have in his technical luggage and toolbox, basic knowledge and minimal expertise with BBs, this option being considered a suitable alternative, particularly in emergency situation where the patient is already intubated and/or in case of difficult airways. One should keep in mind that extubation or re-intubation after DLT might be difficult too, and additional intubation tools are necessary for the safety conditions.


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