Laryngeal mask combined with bronchial blocker provides an alternative for lung isolation but lacks adequate access to the non-dependent lung. Substituting the blocker with a bronchial tube may overcome this limitation. In this report, a #4.5 cuffed bronchial tube was introduced into the non-dependent lung through a second-generation laryngeal mask for transthoracic oesophagectomy. During the 2.5-hour thoracotomy, one-lung ventilation was achieved by isolating the left lung with the bronchial tube and ventilating the right lung via the laryngeal mask, using volume-control mode (7 mL/kg × 12/min) with PIP21–23 cm H2O, pH 7.36 and PaCO2 38.3. Prior to thoracotomy closure, suction and reinflation of the left lung were performed through the bronchial tube. Bronchoscopy via the laryngeal mask revealed no injury to the airway after removal of the bronchial tube. The case shows that laryngeal mask combined with bronchial intubation provides one-lung ventilation with access to the isolated lung.
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Contributors FK: wrote the first draft of the manuscript and provided patient care. JL: contributed the protocol design and critical revision of the manuscript, and provided patient care. GZ: conceived the methodology, designed the protocol, revised and finalised the manuscript. All authors approved the final version of the manuscript and agreed to be accountable for the accuracy and integrity of the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests GZ holds the US patent 'Combined laryngeal-bronchial lung separation system' US10,441,735 B1, which has no direct financial relation to this case. All other authors declare no conflict of interests.
Provenance and peer review Not commissioned; externally peer reviewed.
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