REVIEW ARTICLE
Year : 2021  |  Volume : 15  |  Issue : 3  |  Page : 300-311

Difficult lung separation. An insight into the challenges faced during COVID-19 pandemic


Department of Anesthesiology, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia

Correspondence Address:
Alaa M Khidr
Anesthesiology Department, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Saudi Arabia, P.O. 40289 Al Khobar 31952, Al Khobar
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.sja_1086_20

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Difficult lung isolation or separation in patients undergoing thoracic surgery using one-lung ventilation might be attributed to upper airway difficulty or abnormal anatomy of the lower airway. Additionally, adequate deflation of the surgical lung can impair surgical exposure. The coronavirus disease 2019 (COVID-19) has a harmful consequence for both patients and anesthesiologists. Management of patients with difficult lung isolation can be challenging during the COVID-19 pandemic. Careful planning and preparation, preoperative routine testing, protective personal equipment, standard safety measures, proper preoxygenation, and individualize the patients care are required for successful lung separation. A systematic approach for management of difficult lung separation is centered around securing the airway and providing adequate ventilation using either a blocker or double-lumen tube. Several measures are described to expedite lung collapse.


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