Inability to re-inflate a deflated lung due to double-lumen tube malposition during one-lung ventilation: A unique case

• Author Details:   
• Kapil Singhal ^*
• Kritika Agrawal
• Deepak Kumar Thapa

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Accurate positioning of a double-lumen tube (DLT) is critical for effective one-lung ventilation (OLV) in thoracic anaesthesia. We report the case of a 53-year-old male who underwent thoracotomy and chest wall reconstruction following a severe road traffic accident. After initial successful OLV, difficulty in re-inflating the non-dependent lung led to desaturation. Immediate corrective measures revealed DLT malposition with the bronchial cuff obstructing the right bronchus. Fiberoptic bronchoscopy (FOB) was used to reposition the DLT, restoring adequate ventilation. This case highlights the risks of DLT displacement during surgical repositioning and emphasizes the importance of continuous vigilance, routine FOB use for placement confirmation, and prompt corrective action when complications arise. The inability to re-inflate a deflated lung, as observed here, is a rare complication, emphasizing the need for heightened awareness and well-established protocols for managing such events.

Keywords: One-lung ventilation, Double-lumen tube, Fiberoptic bronchoscopy, Malposition