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Optimal depth of insertion of left-sided double-lumen endobronchial tubes cannot be predicted from body height in below average-sized adult patients

Published online by Cambridge University Press:  23 December 2005

M. Yasumoto ,
K. Higa ,
K. Nitahara ,
S. Shono  and
T. Hamada
M. Yasumoto
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
K. Higa
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
K. Nitahara
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
S. Shono
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
T. Hamada
Affiliation:
Fukuoka University School of Medicine, Department of Anesthesiology, Fukuoka, Japan
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Extract

Summary

Background and objective: The optimal depth of insertion of left-sided double-lumen endobronchial tubes is strongly correlated with body height in average-sized adults. However, this relationship has not been studied in below average-sized adult patients. We investigated whether or not there is a clinically useful relationship in below average-sized adult patients. Methods: One hundred and ninety six consecutive adult patients undergoing thoracic surgery under one-lung anaesthesia (body height ≤ 155 cm) were included in this study. Left-sided double-lumen tubes were inserted under the guidance of a fibre-optic bronchoscope. Optimal depth was defined as the proximal surface of the bronchial cuff positioned just below the carina. Results: There was a statistically significant positive correlation between body height and the optimal depth of insertion (r = 0.61, P < 0.0001); however, the correlation coefficient was low. The actual optimal depth of insertion of one patient was even 4.5 cm shorter than that obtained from the equation. Conclusion: Although there was a statistically significant correlation between body height and the optimal depth of insertion of left sided double lumen tubes in adult patients of short stature (≤ 155 cm), clinical application of the equation is not warranted and these tubes should be inserted under direct vision with a fibre-optic bronchoscope.

Keywords

ANAESTHESIA, GENERALINTUBATION INTRATRACHEAL, endobronchial intubation, insertion techniqueBODY HEIGHT
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 1 , January 2006 , pp. 42 - 44
Copyright
© 2006 European Society of Anaesthesiology

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References

Benumof JL, Partridge BL, Salvatierra C, Keating J. Margin of safety in positioning modern double-lumen endotracheal tubes. Anesthesiology 1987; 67: 729–738.Google Scholar
Brodsky JB, Benumof JL, Ehrenwerth J, Ozaki GT. Depth of placement of left-sided double-lumen endobronchial tubes. Anesth Analg 1991; 73: 570–572.Google Scholar
Bahk JH, Oh YS. Prediction of double-lumen tracheal tube depth. J Cardiothorac Vasc Anesth 1999; 13: 370–371.Google Scholar
Dyer RA, Heijke SAM, Russell WJ, Bloch MB, James MF. Can insertion length for a double-lumen endobronchial tube be predicted? Anaesth Intens Care 2000; 28: 666–668.Google Scholar
Chow MY, Goh MH, Ti LK. Predicting the depth of insertion of left-sided double-lumen endobronchial tubes. J Cardiothorac Vasc Anesth 2002; 16: 456–458.Google Scholar
Sakuragi T, Kumano K, Yasumoto M, Dan K. Rupture of the left main-stem bronchus by the tracheal portion of a double-lumen endobronchial tube. Acta Anaesthesiol Scand 1997; 41: 1218–1220.Google Scholar
Chow MYH, Liam BL, Lew TWK, Chelliah RY, Ong BC. Predicting the size of a double-lumen endobronchial tube based on tracheal diameter. Anesth Analg 1998; 87: 158–160.Google Scholar
Shinnick JP, Freedman AP. Bronchofiberscopic placement of a double-lumen endotracheal tube. Crit Care Med 1982; 10: 544–545.Google Scholar
Gilbert TB, Goodsell CW, Krasna MJ. Bronchial rupture by a double-lumen endobronchial tube during staging thoracoscopy. Anesth Analg 1999; 88: 1252–1253.Google Scholar
Cheong KF, Koh KF. Placement of left-sided double-lumen endobronchial tubes: comparison of clinical and fiberoptic-guided placement. Br J Anaesth 1999; 82: 920–921.Google Scholar