Prone DLT's

[Lizard1]

Radiologist just called me about a case tomorrow that I volunteered for thinking it was a quick kypho

85 yo with CA mets to liver and perihilar region. Don't know primary but anyways he's trying to do an RF ablation on this tumor that's perhilar and sitting next to the Aorta. Doing this under CT and is going to err on the side of the bronchus rather than the Aorta. A partner did this 2 wks ago with DLT in case bleeding occurs in the airway but the radiologist did this from a lateral approach.

Now he wants to try this from a posterior approach but I informed him that we don't have the face cushion designed to handle a DLT sticking out of the mouth (all we have are those pink foam pads that you have to cut out a path for the ET to snake out the side.

So it got me thinking - is there such a face pad to accomodate a DLT in the prone position? Has anybody done one?

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[militarymd]

Univent

bronchial blocker


or just just the regular pillow

 

[jwk]

There are a number of foam pads specifically designed for prone cases. Ours has a layer of white low density foam on top of a layer of blue higher density foam, with cutouts for eyes and nose, and space for routing a tube out either side. It's probably 6 inches thick altogether. It would work fine for a double lumen tube.

The endobronchial blocker is an interesting approach to try.

 

[nimbus]

I've never tried it with a DLT but the Proneview has a lot of space for stuff coming out of the patient's mouth. It should work well with a DLT, allowing position adjustment if necessary.

http://www.dupacoinc.com/product2.htm