First experience with fiberoptically directed wire-guided endobronchial blockade in severe pulmonary bleeding in an emergency setting

We report the first use of a new wire-guided endobronchial blocker in a cri tical respiratory situation caused by localized pulmonary bleeding. During emergency management, it became increasingly difficult to ventilate a multi ple-trauma patient with a conventional single-lumen tube because of massive bleeding through the bronchus of the left lower lobe. Using the Arndt endo bronchial blocker set (William Cook Europe A/S; Bjaeverskor, Denmark), we w ere able to prevent the spread of hemorrhaging and achieved effective venti lation and marked improvement in gas exchange. This new device allows the e ffective blockade of an isolated lobe under direct bronchoscopy to buy time for further intervention.