Comparison between computerized tomography-guided bronchial width measurement versus conventional method for selection of adequate double lumen tube size

Suvvari, Praneeth; Kumar, Bhupesh; Singhal, Manphool; Singh, Harkant

doi:10.4103/aca.aca_117_18

Cited by 6 publications

(1 citation statement)

References 21 publications

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“…At present, the LDLT is usually selected according to the conventional experience, such as gender, height, when the anesthesia department of most domestic hospitals conducts thoracic surgery, but it has low accuracy. Since there is no significant correlation between patient height and airway diameter, this approach tends to lead to inappropriate LDLT selection in Asians ( 14 ). According to Miller's anesthesiology, in female with height <152 cm, 32 Fr should be chosen, height <160 cm, 35 Fr should be chosen, and height > 160 cm, 37 Fr should be chosen.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Left Double-Lumen Tube Size by Measurement of Cricoid Cartilage Transverse Diameter by Ultrasound and CT Multi-Planar Reconstruction

et al. 2021

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Background: Currently, there is no uniform standard for selecting the left double lumen tubes (LDLT). Advantages, such as safety and convenience of the ultrasonic technology, and measurement accuracy, make it more widely applied in the clinical anesthesia, and computed tomography (CT) multi-planar reconstruction (MPR) technology will certainly provide a more accurate measurement. For better application for thoracic surgery choice LDLT, relieving the injury to patients, and reducing the complications, this study will compare the two approaches.Methods: The first part, 120 cases of patients were selected according to the height and gender; recording the patient's optimum LDLT and measurement the transverse diameter of the cricoid cartilage (TD-C) by ultrasound and CT MPR, and then obtained the TD-C range measurement by ultrasound and CT MPR corresponding to different types of LDLT. The second part, total of 102 patients were divided into the ultrasound group and the CT MPR group. In the ultrasound group, TD-C was measured by ultrasound, the corresponding size for intubation was selected based on the conclusions derived from the first part. In the CT MPR group, TD-C was measured by CT MPR, the corresponding size of LDLT based on the conclusions derived from the first part.Results: In the first part, 120 patients were no significant difference in the basic characteristics (P > 0.05). The accuracy of selecting the LDLT by conventional experience, namely height and gender was 58.3%. Ultrasonic measurement TD-C range was as follows: 32 Fr <15.88, 35 Fr: 15.88–16.80, 37 Fr: 16.75–17.81, and 39 Fr > 17.80. CT MPR measurement TD-C range was as follows: 32 Fr <15.74, 35 Fr: 15.74–16.65, 37 Fr: 16.56–17.68, and 39 Fr > 17.65. In the second part, there was no significant difference in the basic characteristics between the two groups (P > 0.05). The accuracy of intubation in the ultrasound group was 90.2% and the corresponding in the CT MPR group was 94.1% (P > 0.05).Conclusions: The accuracy of selecting the LDLT based on TD-C is significantly higher than conventional experience; it can significantly reduce the post-operative complications and there was no statistical significance in the accuracy of LDLT selected for TD-C measurement by ultrasound vs. CT, and both of them could be safely used for the evaluation before intubation under anesthesia in thoracic surgery.

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Section: Discussionmentioning

confidence: 99%

Prediction of Left Double-Lumen Tube Size by Measurement of Cricoid Cartilage Transverse Diameter by Ultrasound and CT Multi-Planar Reconstruction

et al. 2021

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Relationship Between Computed Tomography–Derived Left Bronchial Diameter and Double- Lumen Endotracheal Tube Size Selection

Smeltz,

Wicker,

Belliston-Fowkes

et al. 2024

Journal of Cardiothoracic and Vascular Anesthesia

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Comparison of the accuracy of three methods measured the length of the right main stem bronchus by chest computed tomography as a guide to the use of right sided double-lumen tube

Liu

Zhao

et al. 2022

BMC Anesthesiol

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Background The variation of right main stem bronchus leads to the orifice of the right upper lobe bronchus may be obstructed or increase the incidence of malposition intraoperatively when the right sided double-lumen tube is used. Therefore, the aim of this study was to compare the accuracy of three methods measured the length of the right main stem bronchus via chest computed tomography as a guide to the use of right sided double-lumen tube. Methods In this study, 168 adult patients undergoing left sided thoracic surgery were included. All these patients were allocated to carina-proximal (C-P) group, carina-distal (C-D) group and carina-carina (C-C) group. The position of endobronchial cuff observed via Fiberoptic bronchoscopy after successful initial placement and after turning the patients to the lateral decubitus position, as well as the incidence of malposition of right sided double-lumen tube intraoperative were recorded to assess the accuracy of three methods in predicting the position of right sided double-lumen tube. Results The distance between the carina to the proximal margin of the right upper lobe orifice, carina to the distal margin of the right upper lobe orifice and carina to the first right interlobar carina of the right upper lobe orifice were 17.2 ± 2.3 mm, 25.4 ± 3.7 mm and 28.5 ± 3.1 mm (P < 0.05). In the C-D group, the number of endobronchial cuffs seen to be herniating out of the carina, the number of bronchoscopies during initial placement and on the lateral position, the number of total malposition intraoperative and the number of reposition manoeuvres intraoperative were significantly less than the C-P group or the C-C group (P < 0.05). Conclusions The length of the right main stem bronchus measured by the carina to distal margin of right upper lobe orifice method was more accurate than the other two methods in guiding the use of right sided double-lumen tube. Trials registration Clinical Trials. gov. no. NCT04127903. Registered at https://register.clinicaltrials.gov on 16/10/2019.

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Comparison between computerized tomography-guided bronchial width measurement versus conventional method for selection of adequate double lumen tube size

Cited by 6 publications

References 21 publications

Prediction of Left Double-Lumen Tube Size by Measurement of Cricoid Cartilage Transverse Diameter by Ultrasound and CT Multi-Planar Reconstruction

Prediction of Left Double-Lumen Tube Size by Measurement of Cricoid Cartilage Transverse Diameter by Ultrasound and CT Multi-Planar Reconstruction

Relationship Between Computed Tomography–Derived Left Bronchial Diameter and Double- Lumen Endotracheal Tube Size Selection

Comparison of the accuracy of three methods measured the length of the right main stem bronchus by chest computed tomography as a guide to the use of right sided double-lumen tube

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