A Practical Guide for Using the EZ-Blocker Endobronchial Blocker: Tips and Tricks After 10 Years of Experience.

Autor: Rispoli M; Anesthesia and Intensive Care Unit, Department of Critical Care, AO dei Colli-Monaldi Hospital, Naples, Italy. Electronic address: marco.rispoli@ospedalideicolli.it., Nespoli MR; Anesthesia and Intensive Care Unit, Department of Critical Care, AO dei Colli-Monaldi Hospital, Naples, Italy., Ferrara M; Anesthesia and Intensive Care Unit, ASL Napoli 1, PO San Paolo Hospital, Naples, Italy., Rosboch GL; Department of Anesthesia, Intensive Care and Emergency, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy., Templeton LB; Department of Anesthesiology, Wake Forest University School of Medicine, Winston, Salem, NC., Templeton TW; Department of Anesthesiology, Wake Forest University School of Medicine, Winston, Salem, NC., Massullo D; Division of Anesthesiology, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy., Fiorelli S; Anaesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Rome, Italy., Granell Gil M; Department of Anesthesiology, Critical Care and Pain Medicine, General University Hospital Consortium of Valencia, Valencia, Spain., Coccia C; Istituto di Ricovero e Cura a Carattere Scientifico IFO, Istituto Tumori Regina Elena, Rome, Italy., Piccioni F; Anesthesia Unit 1, Department of Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital, Rozzano, Milan, Italy.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2023 Oct; Vol. 37 (10), pp. 1884-1893. Date of Electronic Publication: 2023 Jun 15.
DOI: 10.1053/j.jvca.2023.06.015
Abstrakt: The EZ-Blocker (EZB) is a "Y-shaped," semirigid endobronchial blocker used for lung isolation and one-lung ventilation during thoracic surgery. Like many medical tools, initial efforts to use this endobronchial blocker may prove challenging for the uninitiated. However, some tips and tricks can be applied fairly rapidly to aid the clinician in properly placing the device, and, furthermore, may help the clinician get the most out of this innovative device. This article focuses on some of the technical aspects of its placement that the authors have developed over time. Additionally, other facets and potential pitfalls are discussed that relate to intraprocedural issues that may sometimes arise when using this device. The following aspects of the EZB as a lung-isolation device are discussed: standard positioning techniques, alternative positioning techniques, use in pediatric patients, approaches to achieving exceptional lung isolation, advanced uses, and limitations and potential issues. Although some information was taken from the authors' rather extensive experience with using this endobronchial blocker, some of the relevant literature are also reviewed, with the goal of being to improve the reader's knowledge of the device and improve the likelihood of its successful placement. The underlying design of the EZB remains unique among commercially available bronchial blockers in improving positional stability. The Y-shaped conformation, however, can lead to challenges when positioning the device in some patients. Therefore, some very practical tips and tricks are provided to assist the clinician in correctly positioning the device and other hints to improve the quality of lung isolation and surgical conditions.
Competing Interests: Declaration of Competing Interest M. Rispoli and M.R. Piccioni received payment for lectures by Teleflex. G.L. Rosboch received lecture grants from Ambu Italia.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE