A logical approach to the selection and insertion of double-lumen tubes

Current Opinion in Anaesthesiology

Volumn 21, Issue 1, 2008, Pages 37-40

  Russell, W John ^a,b  

^a UNIVERSITY OF ADELAIDE   (Australia)

^b ROYAL ADELAIDE HOSPITAL   (Australia)

Author keywords

Double lumen (tracheobronchial) tube; International Standards Organization; Logical insertion; Standard dimensions

Indexed keywords

ACCURACY; AIRWAY; ANATOMY; ANESTHESIOLOGICAL TECHNIQUES; ANESTHESIST; BRONCHUS; DOUBLE LUMEN TUBE; ENDOBRONCHIAL INTUBATION; HUMAN; MEASUREMENT; PATIENT SAFETY; PRIORITY JOURNAL; REVIEW;

BRONCHI; HUMANS; INTUBATION, INTRATRACHEAL;

EID: 38149107469     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/ACO.0b013e3282f2b3a3     Document Type: Review

References (14)

1. Benumof JL, Partridge BL, Salvatierra C, Keating J. Margin of safety in positioning modern double-lumen endotracheal tubes. Anesthesiology 1987; 67:729-738.
2. Hannallah MS, Benumof JL, Ruttimann WE. The relationship between left mainstem bronchial diameter and patient size. J Cardiothorac Vasc Anesth 1995; 9:119-121.
3. Partridge L, Russell WJ. The margin of safety of a left double-lumen tracheobronchial tube depends on the length of the bronchial cuff and tip. Anaesth Intensive Care 2006; 34:618-620. Although variations in the length of the left main bronchus have been long recognized, the equally important variations in the cuff-tip lengths of tubes have not. This is of equal importance.
4. Jeon Y, Ryu HG, Bahk JH, et al. A new technique to determine the size of double-lumen endobronchial tubes by the two perpendicularly measured bronchial diameters. Anaesth Intensive Care 2005; 33:59-63.
5. Russell WJ, Strong TS. Dimensions of double-lumen tracheobronchial tubes. Anaesth Intensive Care 2003; 31:50-53.
6. ISOTC121 Technical Subcommittee 2. Draft standard ISO DIS16628. Tracheobronchial tubes - recommendations for size designation and labeling. Geneva: International Standards Organization; 2006. The essential guide to inform the exact diameter of the double-lumen (tracheobronchial) tube. Without this standard, there is a significant risk of over-sizing or under-sizing the tube.
7. Hurford WE, Alfille PH. A quality improvement study of the placement and complications of double-lumen endobronchial tubes. J Cardiothorac Vasc Anesth 1993; 7:517-520.
8. Klein U, Karzai W, Bloos F, et al. Role of fiberoptic bronchoscopy in conjunction with the use of double-lumen tubes for thoracic anesthesia: a prospective study. Anesthesiology 1998; 88:346-350.
9. Inoue S, Nishimine N, Kitaguchi K, et al. Double lumen tube location predicts tube malposition and hypoxaemia during one lung ventilation. Br J Anaesth 2004; 92:195-201.
10. Seymour AH, Prasad B, McKenzie RJ. Audit of double-lumen endobronchial intubation. Br J Anaesth 2004; 93:525-527.
11. Russell WJ. A blind guided technique for placing double-lumen endobronchial tubes. Anaesth Intensive Care 1992; 20:71-74.
12. Benumof JL. The position of a double-lumen tube should be routinely determined by fiberoptic bronchoscopy [editorial]. J Cardiothor Vasc Anesth 1993; 7:513-514.
13. Bahk J-H, Oh Y-S. A new simple manoeuvre to position the left-sided double-lumen tube without the aid of fiber-optic bronchoscopy. Anesth Analg 1998; 86:1271-1275.
14. Campos JH, Hallam EA, Van Natta T, Kernstine KH. Devices for lung isolation used by anesthesiologists with limited thoracic experience. Anesthesiology 2006; 104:261-266. A 38% failure rate would seem to be related to insertion without a systematic approach to positioning the bronchial cuff.