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Lung isolation techniques

Martin Ma, MD
Peter D Slinger, MD, FRCPC
Section Editor
Roberta Hines, MD
Deputy Editor
Nancy A Nussmeier, MD, FAHA


Lung isolation techniques are used when it is desirable to ventilate one rather than both lungs. One lung ventilation (OLV) is performed either by using an endobronchial tube or by blocking ventilation of the contralateral lung.

OLV is a standard approach to facilitating surgical exposure for pulmonary surgery, and is increasingly being used for esophageal, cardiac, vascular, and orthopedic spine procedures. Less commonly, OLV is used to prevent soiling from the contralateral lung, which can occur in cases involving infection, pulmonary hemorrhage, or whole lung lavage, or to avoid ventilation of the pathologic lung in cases of bronchopleural fistula or a unilateral bullae/cyst.

Expertise in both laryngoscopy and fiberoptic bronchoscopy (FOB) are necessary prior to placement of OLV devices. Lung isolation is usually achieved by using a left-sided double-lumen endobronchial tube (left DLT) to ventilate the left lung via the bronchial lumen or the right lung via the tracheal lumen. Right DLTs are used less frequently due to technical considerations. Bronchial blockers allow the isolation of a lung (or a segment of a lung) using a single-lumen endotracheal tube.

This topic will discuss the devices used for lung isolation (DLTs and bronchial blockers), as well as the choice of the most appropriate device for various clinical situations. Indications for OLV, physiology, management, and complications are reviewed elsewhere. (See "General principles of one lung ventilation".)


The three types of lung isolation devices are:

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Literature review current through: Oct 2017. | This topic last updated: Jul 07, 2017.
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