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Anesthesiology Research and Practice
Volume 2012 (2012), Article ID 207598, 5 pages
http://dx.doi.org/10.1155/2012/207598
Review Article

Lung Separation in the Morbidly Obese Patient

Department of Anesthesia, University of Iowa Healthcare, Iowa City, IA 52242, USA

Received 26 July 2011; Revised 14 October 2011; Accepted 4 November 2011

Academic Editor: Lebron Cooper

Copyright © 2012 Javier H. Campos and Kenichi Ueda. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Lung separation techniques in the morbidly obese patient undergoing thoracic or esophageal surgery may be at risk of complications during airway management. Access to the airway in the obese patient can be a challenge because they have altered airway anatomy, including a short and redundant neck, limited neck extension and accumulation of fat deposition in the pharyngeal wall contributing to difficult laryngoscopy. Securing the airway is the first priority in these patients followed by appropriate techniques for lung separation with the use of a single-lumen endotracheal tube and a bronchial blocker or another alternative is with the use of a double-lumen endotracheal tube. This review is focused on the use of lung isolation devices in the obese patient. The recommendations are based upon scientific evidence, case reports or personal experience. Fiberoptic bronchoscopy must be used to place and confirm proper placement of a single-lumen endotracheal tube, bronchial blocker or double-lumen endotracheal tube.