One-lung ventilation with use of a double lumen tube in two dogs; when right might be wrong

Abstract

One-lung ventilation (OLV) is an anaesthetic technique utilised for improved visualisation and access of the surgical field during thoracoscopy. The  authors present two cases that underwent OLV with use of a double lumen tube (DLT). The first case was intubated with endoscopic guidance for bronchial port intubation of the right mainstem bronchus. This dog  experienced prolonged periods of intraoperative hypoxemia. Upon case review, it was suspected intubation of the mainstem bronchus resulted in occlusion of the right cranial lung lobe. In the second case, the DLT was placed bronchoscopically into the left mainstem bronchus with the aid of computed tomography (CT). Excellent intraoperative oxygenation was  achieved. When DLTs are used in dogs, their anatomical differences from humans make them susceptible to additional lung occlusion and pulmonary shunting. Computed tomography is recommended as a fundamental  addition to bronchoscopy for correct tube placement.

Keywords: Anaesthesia, Double lumen tube, One-lung ventilation,  Thoracoscopy.