Evaluation of an approach to choosing a left double-lumen tube size based on chest computed tomographic scan measurement of left mainstem bronchial diameter

Tracheal width and left double-lumen tube size: a formula to estimate left-bronchial width

“…Left bronchial width can be measured from a chest radiograph, but as demonstrated in our study and others, the left bronchus can be clearly seen in only 50% to 75% of chest radiographs [6][7][8]. Left bronchial width can also be measured from a chest computed tomography scan [9].…”

“…Hannallah et al [9] reported a weak correlation (r 2 = 0.23) between height and age and LBW in men, and no correlation in women.…”

“…Sex, height, and weight, alone or in combination, have also been used to select DLTs [10,11], despite the fact that other researchers failed to demonstrate any combination of these factors that consistently predicts LBW [8,9]. Hannallah et al [9] reported a weak correlation (r 2 = 0.23) between height and age and LBW in men, and no correlation in women.…”

Can ultrasound be useful for predicting the size of a left double-lumen bronchial tube? Tracheal width as measured by ultrasonography versus computed tomography

“…However, Chow et al found that the measurement of tracheal diameter from a chest radiograph is less reliable in patients who are of small stature [13]. They and others suggested CT as a possible alternative to measuring directly the diameter of the left main-stem bronchus [14,16,17]. This constitutes an exact and accurate "gold standard" method, but it is not always practical.…”

Use of a neck brace minimizes double-lumen tube displacement during patient positioning

“…10,11 After induction of anesthesia, patients were intubated with a disposable polyvinyl chloride left-sided DLT (Broncho-Cath®, Mallinckrodt Medical Ltd., Athlone, Ireland) using a conventional method. 9 Subsequently, the head was returned to the neutral position and a Miami J® neck collar was applied in the brace group.…”