Table 4.

Indications for Lung Isolation

		Indications	Main Goal	Suggestion
Absolute indications		Unilateral lung abscess or cyst	Contralateral lung protection	DLT
		Unilateral lung hemorrhage (eg, thromboembolism, aneurysm)	Contralateral lung protection	DLT
		Bronchoalveolar lavage with saline to treat alveolar proteinosis	Contralateral lung protection	DLT
		Bronchopulmonary fistula, trachea-bronchial injury	Secure the airways and gas exchange	DLT
		Severe unilateral disease (giant emphysematous bullae)	Differential lung ventilation	DLT
		Lung transplantation	Secure the airways and differential ventilation	DLT
Relative indications	High priority	Pneumonectomy, sleeve resection on the bronchial mainstem Tumor obstructing the main bronchial stem	Surgical exposure	DLT
		Thoracic aneurysm with cardiopulmonary bypass	Surgical exposure	DLT > BB
		Lobectomy and lesser lung resection (any surgical approach)	Surgical exposure	DLT = BB
	Low priority	Interventions on the pleura and mediastinal structures	Surgical exposure	DLT = BB
		Esophagectomy	Surgical exposure	DLT = BB
		Orthopedic surgery on the chest, thoracic spine surgery	Surgical exposure	DLT = BB
		Minimally invasive cardiac surgery	Surgical exposure	DLT = BB
		Bilateral cervical sympathectomy	Surgical exposure	BBs > DLT

NOTE. In cases of absolute lung “isolation,” double-lumen tubes should be used. In other cases, the indication for bronchial blockers should be considered according the suggestions in the text

Abbreviations: BB, bronchial blocker; DLT, double-lumen tube; VATS, video-assisted thoracoscopy.