Unanticipated Difficult Airway in a Patient Undergoing Double Lumen Tube Placement: A Case Study

For patients undergoing thoracic procedures extending into the chest wall, placement of doublelumen endotracheal tubes is necessary to provide one-lung ventilation to maintain an optimum surgical field. Technical difficulty increases with double-lumen endotracheal tube (DLT) placement. Standard of practice dictates that the Macintosh (Mac) laryngoscope increases first pass success. Newer video laryngoscopy devices such as the GlideScope, C-MAC, or Airtraq may provide an enhanced glottic view leading to successful DLT placement. This case study presents a patient undergoing a chest wall mass removal who presented with an unanticipated difficult airway during DLT intubation. The purpose is to review and evaluate the use of video laryngoscopy for first pass success during DLT placement compared to the Mac laryngoscope and provide evidence to support a superior laryngoscopy tool.