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Lung Isolation Versus Lung Separation: Double-Lumen Tubes

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Anesthesia in Thoracic Surgery

Abstract

The separation of the lungs today means a completed “anatomical” sealing as obtained with a double-lumen tube (DLT), and the isolation of the lung means a “functional” sealing as with a bronchial blocker (BB). In the first case, there are some absolute indications in which a protective strategy for the contralateral lung is needed, including potentially life-threatening conditions. Maintenance of adequate gas exchange, prevention of soiling/flooding the other lung with contaminated material/blood and avoidance of barotrauma are best achieved with DLTs in these situations. Some specific surgical interventions require lung separation with a DLT. In all the other situations, in which lung separation is a relative indication, lung isolation with a BB could be best considered. Overall, the DLT remains the gold standard technique in various surgical procedures requiring lung separation/isolation and are favored by most thoracic anesthesiologists worldwide. This chapter discusses the differences between lung isolation and lung separation, their respective indications, as well as the means of achieving it. Double-lumen tubes (either right or left sided) are presented with their advantages/disadvantages as compared to bronchial blockers.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium

    Laszlo L. Szegedi

  2. Department of Anesthesiology, Hôpitaux Universitaires de Geneve, Geneva, Switzerland

    Marc Licker

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  1. Laszlo L. Szegedi
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  2. Marc Licker
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Correspondence to Marc Licker .

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Editors and Affiliations

  1. Consorcio Hospital General Universitario, Valencia, Spain

    Manuel Granell Gil

  2. Istanbul Medical Faculty, Department of Anaesthesiology, Istanbul University, Istanbul, Turkey

    Mert Şentürk

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Szegedi, L.L., Licker, M. (2020). Lung Isolation Versus Lung Separation: Double-Lumen Tubes. In: Granell Gil, M., Şentürk, M. (eds) Anesthesia in Thoracic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-28528-9_4

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  • DOI: https://doi.org/10.1007/978-3-030-28528-9_4

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-28528-9

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