Update on tracheobronchial anatomy and flexible fiberoptic bronchoscopy in thoracic anesthesia

Abstract

Purpose of review: This review is focused on tracheobronchial anatomy and the use of flexible fiberoptic bronchoscopy in thoracic anesthesia.

Recent findings: A complete knowledge of tracheobronchial anatomy is a key factor in determining proper position of lung isolation devices, namely double-lumen endotracheal tubes and bronchial blockers. In addition, changes occur in tracheobronchial anatomy with age; therefore, it is very important that every anesthesiologist is familiar with these anatomical changes in order to recognize anatomical landmarks and perform a successful placement of lung isolation devices. Flexible fiberoptic bronchoscopy must be considered an art in the practice of thoracic anesthesia.

Summary: Recognition of tracheobronchial anatomy and familiarity with the use of flexible fiberoptic bronchoscope are key components while managing patients undergoing thoracic surgery and anesthesia.