Emergency Medicine

Ventilating in isolation: the Papworth BiVent tube

Achieving the isolation and ventilation of only one of two lungs is technically demanding, especially for those anaesthetists who perform this procedure infrequently. To help meet this challenge more effectively, physicians at Papworth Hospital in Cambridge have developed a new double-lumen endotracheal tube to facilitate rapid and effective lung isolation.

In adults, lung isolation is normally carried out through the use of a double lumen tube (DLT) with a cuffed endobronchial limb, or through the occlusion of a bronchus using a bronchus blocker. Although not in routine use for adult patients since the adoption of double lumen tubes (despite continued use for paedriatric thoracic anaesthesia), bronchus blockers have recently experienced a renaissance of sorts. This reemergence of interest is due in large measure to the introduction of novel bronchus blockers, which are finding increasing application in elective thoracic procedures and in clinical settings requiring rapid lung isolation.

The Papworth BiVent Tube the rapid and effective isolation of single lungs using any bronchus blocker, and without the need for fibreoptic endoscopic guidance. In an advance online publication in Anaesthesia, Sunit Ghosh and colleagues of Papworth hospital outline the development of the BiVent Tube, and describe its use on an airway training manikin. The results of this study indicate that the Papworth BiVent Tube can be used to intubate the trachea more easily and more rapidly than a traditional DLT. In combination with a bronchus blocker, the device enables lung isolation in an easier and more rapid fashion than a single bronchus tube with a bronchus blocker.

Although further clinical studies are required for a more thorough validation of the Papworth BiVent Tube, these initial results appear promising, and indicate the availability of a useful new tool for anaesthetists.

Article by Ghosh et al. on Papworth BiVent tube, Anaesthesia, June 2008 [advance online publication]