Thoracic 1

Question 1

Indications for One lung ventilation:

Answer 1

VATS
Prevent spillage of pus or blood 
Bronchopleural or bronchicutaneous fistula 
Large unilateral villas or cysts 
Pneumonectomy (realative)

Question 2

Difference between R and L endobronchial tube?

Answer 2

Right has a slotted area to ventilate the right upper lobe left does not

Question 3

When a DLT is positioned by auscultatin alone, what percentage are placed incorrectly?

Answer 3

48%

Question 4

If a left sided DLT is advanced into the right side-then what?

Answer 4

The Right upper lobe won’t be ventilated, leading to continual hypoxemia

Question 5

What happens in a DLT if the tracheal cuff is below the carina?

Answer 5

Absent or Diminished breath sounds over the contralateral side. Fix it by pulling it back.

Question 6

If bronchial cuff of DLT isn’t inserted far enough, then…

Answer 6

Then when you inflate it, you can cause inability for gas to flow from tracheal lumen into the lungs

Question 7

How many CC of air should you give with DLT? Always do what before repositioning?

Answer 7

2-3 cc. Always deflate the bronchial cuff to prevent bronchial rupture

Question 8

What is the order of what you must do if you have gradual desaturation during OLV?

Answer 8

1. Increase FiO2 to 100%
2. PEEP to ventilated lung (PV)
3. CPAP to Non-ventilated lung
4. Restrict blood flow to non-ventilated lung by cloning the pulmonary artery