What are the best strategies for one-lung ventilation in tracheostomized patients? This retrospective analysis examines airway management techniques and outcomes in 56 tracheostomized patients requiring one-lung ventilation. The study, conducted at a German University Hospital, assessed patient demographics, ventilation parameters, and adverse events over a six-year period. In 42 cases, a tracheostomy tube was combined with a bronchial blocker, while a double-lumen tracheostomy tube was used in 10 cases. The management of one-lung ventilation in tracheotomized patients presents unique challenges. While double-lumen tracheostomy tubes have specific advantages, the research recommends considering their use carefully. For most tracheotomized patients, bronchial blockers in conjunction with a tracheostomy tube are used, which offers safety and practicality, irrespective of the tracheostomy's age or type. The authors suggest further research and randomized controlled trials are warranted to establish best practices for one-lung ventilation in this unique patient population.
This article is a relevant addition to The Thoracic and Cardiovascular Surgeon, addressing a specific surgical challenge related to lung ventilation. The paper directly contributes to the journal’s scope by providing a detailed analysis of airway management, with findings applicable to thoracic surgeons and anesthesiologists.