The Rueschelet Tracheoport (W.Ruesch AG, Kernen, Germany) is a double-lumen tracheal tube specifically designed for lung isolation in tracheotomised patients, having limited diffusion.12 An alternative approach involving the use of a single-lumen tracheal tube with an enclosed bronchial blocking device positioned using a bronchoscope, provides the advantage of a smaller sized tube compared to a double-lumen tracheal tube. The Univent tube is a single-lumen tube associated with a bronchial blocker presenting, when positioned, a small internal lumen through which continuous positive airway pressure (CPAP) can be applied during ventilation

of the contralateral lung.13 In tracheotomised Caspase inhibitor review patients requiring one-lung ventilation, an independent bronchial blocker (Arndt

blocker or Cohen blocker) can also be introduced through a tracheotomy cannula. In our case, the possibility of anchoring the tube in at least one of the main bronchi had to be considered. The approach, based on the application of a cuffed left double-lumen tracheal tube in the homolateral main bronchus, was not viable due to the dimensions of the residual trachea. Therefore, both main this website bronchi were intubated with two single-lumen tubes of adequate size. Since separate lung ventilation was not necessary in our case, a Y-shaped connector was positioned at the distal end of the tubes, and then connected to the mechanical ventilator. This allowed us to apply the same ventilation mode for both lungs with a homogeneous

distribution of tidal volume. Ventilation was continued for several diglyceride days without any leaks, maintaining stable ventilatory settings and without complications. After extubation, bronchoscopy was performed showing no lesions in either bronchial hemisystem. The above described selective intubation of the bronchial hemisystems can certainly be considered to be a procedure involving risk of complications such as possible malposition of endotracheal tubes and bronchial rupture, although such complications are also described with double-lumen tracheal tubes.14 However, under extreme conditions, when traditional ventilation methods cannot be applied for anatomical reasons, the above described approach may be attempted, especially when a short period of mechanical ventilation is required. “
“Churg–Strauss syndrome (CSS), also called allergic granulomatosis and angiitis, is an uncommon multisystem disorder of unknown etiology, characterized by necrotizing vasculitis affecting small to medium-sized vessels (1). Patients usually present with a history of asthma, allergic rhinitis and prominent peripheral blood eosinophilia.2 CSS in childhood is rare and the clinical presentation can be quite diverse. Although CSS is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, ANCA in children are only found in 40% of the cases.3 and 4 Therefore, diagnosing CSS in children may be difficult.