Independent lung ventilation using a double-lumen endobronchial tube by nasotracheal intubation

Independent lung ventilation (ILV) is effective for the patient who is suffering from unilateral lung disease. When we ventilate the patients with ILV, they should be intubated with a double-lumen endobronchial tube. While ILV is continued for some time a number of difficulties related to the management of the double-lumen endobronchial tube (DLT) arise. Movements of the patient and routine turning of the patient threaten the DLT position and can lead to loss of lung isolation or lobe occlusion. Nasal intubation is better suited for long-term intubation than oral intubation because it is safer tor equipment attachment. We have ventilated six patients (Table) with ILV using the DT by nasotracheal intubation for 25 to 120 h. We intubated Portex #5.5 DT for all cases. There was no case in which DLT was required to correct its position during ILV. Although we examined the condition inside the nose, there was no severe damage by the DLT. We concluded that nasotracheal DLT intubation was done safely and could be used for ILV up to 7 days.

Table 1