Practice Patterns in Choice of Left Double-Lumen Tube Size for Thoracic Surgery

Amar, David; Desiderio, Dawn P.; Heerdt, Paul M.; Kolker, Anne C.; Zhang, Hao; Thaler, Howard T.

doi:10.1213/ane.0b013e3181602e41

Cited by 34 publications

(16 citation statements)

References 21 publications

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“…[6] Smaller sizes were required in 2% (6/300) of American adult patients because of the greater difficulty of insertion into the left mainstem bronchus than in the glottis. [7] In the current study, difficulty in passage through smaller cricoid cartilages occurred in seven patients (2.5%, 7/280).…”

Section: Discussionmentioning

confidence: 51%

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Difficulty in inserting left double-lumen endobronchial tubes at the cricoid level in small-statured women: A retrospective study

Sato

Kayashima

2017

Indian J Anaesth

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Background and Aims:Left double-lumen endobronchial tube (DLT) sizes are selected using tracheal diameters and left mainstem bronchial diameters (LMBDs) determined from chest radiographs or computed tomography (CT) scans. In Western women, 35-Fr or 37-Fr DLTs are often selected. However, difficulties can be encountered when inserting 32-Fr or 35-Fr DLTs in Japanese women. We investigated success rates for 32-Fr or 35-Fr DLT insertion in Japanese women and determined the causes of unsuccessful DLT insertion.Methods:We searched anaesthesia records of Japanese women aged ≥20 years who underwent thoracic surgery with 32-Fr or 35-Fr DLTs between April 2010 and March 2015 in our hospital. In the successful group (SG), patients were intubated using the initially selected DLTs. By contrast, in the unsuccessful group (UG), the DLT size had to be changed. The Mann–Whitney U-test and Fisher's exact test were used to compare groups.Results:The SG included 149 (96.1%) of 155 cases of 32-Fr DLT use and 119 (95.2%) of 125 cases of 35-Fr DLT use. Patient height was significantly lower in the UG than in the SG for the 35-Fr DLT (P = 0.0036). In seven of 12 UG patients (three for 32-Fr and four for 35-Fr), the transverse diameters of cricoid cartilages were smaller than the DLTs' tracheal diameters, thereby preventing passage through the cricoid cartilages.Conclusion:Along with LMBDs, transverse diameters of cricoid cartilages based on CT scans or ultrasonogram findings may help in selecting the appropriate left DLT size.

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Section: Discussionmentioning

confidence: 51%

“…[7] In 8 of 32 short Asian women (height, <152 cm), a left DLT <32-Fr in size (8.7 mm outer diameter of the bronchial lumen, Broncho-Cath™; Mallinckrodt, St. Louis, MO, USA) was needed. [6] Moreover, left DLTs <35-Fr (9.6 mm, Broncho-Cath™) in size were needed in 27 of 48 women with heights of 152–160 cm.…”

Section: Discussionmentioning

confidence: 99%

Difficulty in inserting left double-lumen endobronchial tubes at the cricoid level in small-statured women: A retrospective study

Sato

Kayashima

2017

Indian J Anaesth

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“…Tube exchangers are available in a wide range of sizes (11,14,19 Fr), and if necessary can easily adapted for either oxygen insufflation or jet ventilation (Cook Critical Care, Bloomington, IN.). Tube exchangers are available in a wide range of sizes (11,14,19 Fr), and if necessary can easily adapted for either oxygen insufflation or jet ventilation (Cook Critical Care, Bloomington, IN.).…”

Section: Cohen Blocker 4 Uniblockermentioning

confidence: 99%

New Developments in Thoracic Anesthesia

Cohen¹

2010

ASA Refresher Courses in Anesthesiology

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“…A large DLT also gives the best conditions for fiberoptic bronchoscopy and suctioning through the tube. On the other hand, a too-large DLT could cause bronchial rupture [4] and a too-small DLT could be advanced too deeply, obstructing the upper lobe bronchus, although it has been reported that a 35-Fr DLT can be safely used [5].…”

Section: Introductionmentioning

confidence: 99%