Comments to 'A challenging case of tracheal bronchus with concurrent tracheal stenosis for one lung ventilation'

摘要

In this issue of TACC, Pui-San Loh et al. describe an unexpected case of a tracheal bronchus in combination with a significant tracheal stenosis, plus a difficult upper airway anatomy. Both the use of a double-lumen tracheal tube and the use of a bronchial blocker were unsuccessful, ultimately rendering one-lung ventilation impossible. (Reference the case report here) What can we learn from this report? Dr. Loh and his colleagues were unfortunate to encounter a rare concurrency of two unlikely lower airway anatomical variants together with a relatively difficult airway anatomy. However, the way they failed to appreciate the problem before induction, which ultimately led to unexpected failure to establish the one-lung ventilation may teach us a lesson. If the authors could fail, so might we. And if they learned a lesson about airway management or indeed about patient assessment from this case, so may we.