1、四川大学华西医院麻醉科四川大学华西医院麻醉科梁梁 鹏鹏Clinical application of Clinical application of UniventUniventUnivent introductionThe Univent The Univent is a single-lumenis a single-lumen silicone tube with a small silicone tube with a small separate lumen along the anterior concave wall which separate lumen along the
2、anterior concave wall which contains a small hollow nonlatex bronchial blocker that contains a small hollow nonlatex bronchial blocker that can extend about can extend about 8-10 cm 8-10 cm beyond the tip.beyond the tip.The Univent can block The Univent can block either the left or right bronchuseit
3、her the left or right bronchus when inserted through the specially designed endotracheal when inserted through the specially designed endotracheal tube.tube.Univent introductionThe device incorporates a flexible,high torque control The device incorporates a flexible,high torque control blocker with
4、a soft,open lumen tip improving the ability blocker with a soft,open lumen tip improving the ability to manipulate and direct the blocker during a procedure.to manipulate and direct the blocker during a procedure.Smooth Intubation The Univent has an easy to direct malleable shaft for smoothintubatio
5、n into the target bronchus with the ability to reposition.Smooth Manipulation Univents flexible blocker shaft with a soft open lumen tip allows for smooth manipulation.UniventHigh volume,low High volume,low pressure trachealpressure trachealcuff is blue to cuff is blue to help visualize help visuali
6、ze the cuff during the cuff during positioningpositioningSmall hollow,Small hollow,non-latex blockernon-latex blockerhas a soft,has a soft,flexible tipflexible tipHigh torque High torque control control malleable shaft malleable shaft for smooth for smooth intubationintubationinto target into target
7、 bronchusbronchusStructure of UniventFeatures Of Univent1.Endotracheal intubation can be performed in the 1.Endotracheal intubation can be performed in the conventional manner,just like conventional manner,just like a single lumen a single lumen endotracheal tube.endotracheal tube.2.One-lung ventila
8、tion can be achieved by placement of 2.One-lung ventilation can be achieved by placement of the blocker to the blocker to either the left or right lungeither the left or right lung,or to lung,or to lung segments in either lung.segments in either lung.3.Insufflation and CPAP can be achieved through 3
9、.Insufflation and CPAP can be achieved through the the lumen of the blocker shaft.lumen of the blocker shaft.4.Blocked lung can be collapsed by 4.Blocked lung can be collapsed by aspirating air aspirating air through the blocker lumen.through the blocker lumen.5.The blocker can 5.The blocker can be
10、retracted into its pocket be retracted into its pocket to to facilitate post operative ventilation.facilitate post operative ventilation.Endotracheal tube with an easy-to-direct torque Endotracheal tube with an easy-to-direct torque control blockercontrol blockerThe Univent allows collapsing of one
11、lung for thoracoscopic procedures.Endotracheal intubation can be performed in the conventional manner,just like asingle lumen endotracheal tube.One-lung ventilation can be achieved by placement of the blocker in either the left or right lung,or lung segments.The blocked lung can be collapsed by aspi
12、rating air through the lumen of the blocker shaft.Insufflation and PEEP can also be achieved through the lumen of the blocker shaft.Warnings and PrecautionsAbout Stylets and Aeration CapAbout Stylets and Aeration Capa)The a)The styletsstylets on both ends of the blocker on both ends of the blocker s
13、hould be should be removedremoved and discarded prior to use,and discarded prior to use,as they are placed to maintain the curved as they are placed to maintain the curved shape of the blocker.shape of the blocker.b)b)The aeration cap(blue color)The aeration cap(blue color)attached at attached at th
14、e blocker valve should also be the blocker valve should also be removedremoved and and discarded prior to use,as it is attached discarded prior to use,as it is attached for ventilation during EOG sterilization for ventilation during EOG sterilization process.process.Warnings and PrecautionsAbout Ret
15、raction of Blocker CuffAbout Retraction of Blocker Cuffa)Before retracting the blocker cuff,be sure to evacuate air a)Before retracting the blocker cuff,be sure to evacuate air completely from the completely from the cuffcuff(until the pilot balloon is also (until the pilot balloon is also collapsed
16、collapsed)for smooth retraction.)for smooth retraction.b)b)Lubricant Lubricant(such as Lidocaine jelly)should be applied on the(such as Lidocaine jelly)should be applied on the whole surface of the blocker cuff.whole surface of the blocker cuff.c)c)Pull the blocker Pull the blocker carefully until t
17、he setting end mark carefully until the setting end mark(double-end mark)appears at the proximal end of the blocker(double-end mark)appears at the proximal end of the blocker mantle tube and retract the blocker cuff into the pocket of the mantle tube and retract the blocker cuff into the pocket of t
18、he endotracheal tube.endotracheal tube.d)Do not apply lubricant on the d)Do not apply lubricant on the tip end of the blocker tip end of the blocker shaft shaft as the lubricant may obstruct the blocker shaft lumen.as the lubricant may obstruct the blocker shaft lumen.Warnings and Precautionse)Do no
19、t pull the blocker shaft with excessive force when the e)Do not pull the blocker shaft with excessive force when the setting end mark appears.It may setting end mark appears.It may damage the blocker cuffdamage the blocker cuff.f)In case the tip end of the blocker shaft cant be retracted f)In case t
20、he tip end of the blocker shaft cant be retracted into the pocket of the endotracheal tube,the tube should not into the pocket of the endotracheal tube,the tube should not be used.be used.Warnings and PrecautionsAbout CuffsAbout CuffsConduct inflation test for tracheal cuff and blocker cuff prior to
21、 use.Conduct inflation test for tracheal cuff and blocker cuff prior to use.In case any malfunction such as air leakage or balloon In case any malfunction such as air leakage or balloon herniationherniation has has occurred,the tube should not be used.occurred,the tube should not be used.Maximum inj
22、ection air volume(for inflation test)for tracheal cuff per Maximum injection air volume(for inflation test)for tracheal cuff per size:size:For I.D.6.0,6.5,and 7.0mm max.40mLFor I.D.6.0,6.5,and 7.0mm max.40mLFor I.D.7.5,8.0,8.5,9.0,9.5and 10.0mm max.50mLFor I.D.7.5,8.0,8.5,9.0,9.5and 10.0mm max.50mLM
23、aximum injection air volume(for inflation test)for blocker cuff per Maximum injection air volume(for inflation test)for blocker cuff per size:size:All sizes max.6mLAll sizes max.6mL*Do not over inflate as above specified for inflation test.Do not over inflate as above specified for inflation test.In
24、tubation MethodsA.Tube Rotation MethodTube Rotation MethodInsert the tube orotracheally just like a conventional Insert the tube orotracheally just like a conventional endotracheal tube and rotate the tube 90 degrees endotracheal tube and rotate the tube 90 degrees towards the operative side,so that
25、 the blocker lumen towards the operative side,so that the blocker lumen is on the thoracotomy side(Fig.1)is on the thoracotomy side(Fig.1)Intubation MethodsB.B.Blocker Rotation MethodBlocker Rotation MethodInsert the tube Insert the tube orotracheallyorotracheally,inflate the tracheal tube cuff,infl
26、ate the tracheal tube cuff and fix the tube firmly at the patients mouth with cloth tape.and fix the tube firmly at the patients mouth with cloth tape.Insert FOB into the Insert FOB into the endotrachealendotracheal tube lumen and push while tube lumen and push while twist the blocker tube into the
27、target main stem bronchus under twist the blocker tube into the target main stem bronchus under direct vision with the direct vision with the fiberopticfiberoptic bronchoscope bronchoscope(Fig.2)(Fig.2)Blocker FixationIntubation MethodsClinical application Clinical application Thank you for your attention!
