• G A Arndt, S T DeLessio, P W Kranner, W Orzepowski, B Ceranski, and B Valtysson.
• Department of Anesthesiology, University of Wisconsin Clinical Sciences Center, Madison, USA.
• Acta Anaesthesiol Scand. 1999 Mar 1;43(3):356-8.

BackgroundOne-lung ventilation utilizing a double-lumen endotracheal tube may be technically difficult or inappropriate in morbidly obese or critically ill patients. In patients requiring awake fiberoptic intubation, double-lumen tube placement may be impossible. Wire-guided endobronchial blockade through a conventional endotracheal tube is a new alternative for these patients.MethodsA 44-year-old, 133 kg female patient was scheduled to undergo a thoracotomy for transthoracic fundoplication. A wire-guided endobronchial blocker (WEB) was placed following rapid-sequence induction and intubation with an 8.0 OD single-lumen endotracheal tube with the aid of a pediatric bronchoscope.ResultsThe WEB, using a guiding loop, was placed with ease and allowed effective one-lung ventilation.ConclusionThe WEB system allows one-lung ventilation to be achieved with a conventional endotracheal tube. The need for reintubation at the end of surgery is eliminated and endotracheal tube cross-sectional area is conserved.

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