Flow-controlled One-lung Ventilation During Carinal Sleeve Reconstruction: Anaesthetic Management and Technical Feasibility

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Berktaş C. K., Teloğlu E. Ş., GÜMÜŞ ÖZCAN F., Demirkol E. Y.

Turkish Journal of Anaesthesiology and Reanimation, cilt.54, sa.2, ss.138-142, 2026 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 54 Sayı: 2
  • Basım Tarihi: 2026
  • Doi Numarası: 10.4274/tjar.2026.262398
  • Dergi Adı: Turkish Journal of Anaesthesiology and Reanimation
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.138-142
  • Anahtar Kelimeler: Airway management/methods, anaesthesia, thoracic, flow-controlled ventilation, positive-pressure respiration, tracheal neoplasms/ surgery, ventilation, one-lung
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Carinal sleeve resection with reconstruction represents one of the most challenging thoracic surgical procedures and requires meticulous anaesthetic management to maintain adequate gas exchange within a shared and surgically interrupted airway while preserving an unobstructed surgical field. Conventional ventilation strategies, including cross-field ventilation and high-frequency jet ventilation, may interfere with surgical exposure or result in unstable ventilation. We describe the anaesthetic management of a 64-year-old male patient in whom flow-controlled ventilation- one-lung ventilation (FCV-OLV) was employed during carinal sleeve lobectomy with reconstruction. Following initial double-lumen tube ventilation, FCV was established using a Tritube® connected to an Evone® ventilator and maintained throughout airway reconstruction. Ventilation was achieved without interruptions, apneic periods, or cross-field ventilation. Oxygenation and carbon dioxide elimination remained stable during 180 minutes of FCV, while the small-lumen tube provided optimal surgical exposure. The patient was extubated uneventfully at the end of surgery and experienced an uncomplicated postoperative course. This case highlights the feasibility of flow-controlled OLV as an anaesthetic strategy during complex airway reconstruction. FCV-OLV enabled uninterrupted ventilation, stable gas exchange, and excellent surgical conditions without the need for extracorporeal support or alternative ventilation techniques.