Relocation of a Double-Lumen Tube During Patient Positioning

Riley, Richard H.; Marples, Ivan

doi:10.1213/00000539-199212000-00040

Cited by 21 publications

(8 citation statements)

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“…[2][3][4][5] When patients are turned to the lateral position, outward displacement of DLTs predominates. [5][6][7] Therefore, extension of the head and neck was considered customary during lateral positioning.…”

Section: Résumémentioning

confidence: 99%

Double-lumen tube placement with the patient in the supine position without a headrest minimizes displacement during lateral positioning

Seo

Hong

Lee

et al. 2012

Can J Anesth/J Can Anesth

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Double-lumen tube placement with the patient in the supine position without a headrest minimizes displacement during lateral positioning La mise en place d'une sonde à double lumière chez un patient en decubitus dorsal sans appuie-tête minimise le risque de déplacement au cours du passage en decubitus latéral Abstract Purpose The correct position of double-lumen tubes (DLTs) is customarily confirmed after tracheal intubation by bronchoscopy with the patient supine on a headrest. However, displacement of DLTs usually occurs during lateral positioning because of neck extension. This study was undertaken to determine whether displacement of DLTs could be minimized during lateral positioning if DLTs were positioned without a headrest. Methods One hundred patients scheduled for thoracic surgery were randomized into two groups (n = 50 each). After tracheal intubation using a headrest, adjustment of DLT position was performed according to group assignment, i.e., either with the headrest in place or without the headrest. Using a bronchoscope, distances from the tracheal opening to the main carina and from the bronchial opening to the left bronchial carina were measured in both the supine and lateral positions. Results Displacement of DLTs [mean (standard deviation)] during lateral positioning was greater in the headrest group than in the no-headrest group [12.3 (6.5) mm vs 6.8 (5.5) mm, respectively, in the trachea; 11.6 (6.7) mm vs 6.0 (4.6) mm, respectively, in the bronchus; P \ 0.001]. The incidence of significant displacement, defined as [ 10 mm from initial correct position, was greater in the headrest group than in the no-headrest group (64% vs 28%, respectively, in the trachea; 58% vs 20%, respectively, in the bronchus; P \ 0.001). Conclusion Displacement of DLTs during lateral positioning appears to be caused primarily by extension of the neck. Correct adjustment of DLT position without a headrest in the supine position is an easy and effective method to minimize DLT displacement during lateral positioning (ClinicalTrials.gov number, NCT01413347). RésuméObjectif La bonne position des sondes a`doubles lumie`res (DLT) est d'ordinaire confirme´e par bronchoscopie apre`s intubation trache´ale chez un patient en decubitus dorsal avec appuie-teˆte. Cependant, ces sondes se de´placent habituellement au cours d'un changement de position en decubitus late´ral en raison d'une extension du cou. Cette e´tude a e´te´entreprise pour de´terminer si le de´placement des DLT pouvait eˆtre minimise´au cours d'un passage en This article is accompanied by an editorial, please see Can J Anesth 2012; 59: this issue.

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Section: Résumémentioning

confidence: 99%

Double-lumen tube placement with the patient in the supine position without a headrest minimizes displacement during lateral positioning

Seo

Hong

Lee

et al. 2012

Can J Anesth/J Can Anesth

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“…7 It is well demonstrated that the position of the DLT during anesthesia may be altered by surgical manipulation, patient coughing, or by moving the head, the neck or the entire patient. 8 Desiderio et al demonstrated that the Sher-I-Bronch TM (Sheridan, Argyle NY, USA) DLT moved in 72% of cases during lateral positioning and this regardless of endobronchial cuff inflation. 9 This movement is predominantly in the upward direction.…”

Section: Discussionmentioning

confidence: 99%

New landmarks improve the positioning of the left Broncho-Cath™ double-lumen tube-comparison with the classic technique

Fortier

Côté

Bergeron

et al. 2001

Can J Anesth/J Can Anesth

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“…4 5 DLT position can change intraoperatively due to surgical manipulation, 137 changing patient head position, 104 or both, but turning the patient to the lateral position is a very common cause of outward tube movement. 99…”

Section: Figmentioning

confidence: 99%

Lung separation and the difficult airway

Brodsky

2009

British Journal of Anaesthesia

115

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Selective collapse of a lung and one-lung ventilation (OLV) is now performed for most thoracic surgical procedures. Modern double-lumen endobronchial tubes and bronchial blockers have made lung separation safe and relatively easy to achieve. However, OLV in the patient with a 'difficult airway' can present a challenge to the anaesthesiologist. This review considers the different techniques used to achieve lung separation and their application to the patient with a difficult airway.

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Relocation of a Double-Lumen Tube During Patient Positioning

Cited by 21 publications

References 0 publications

Double-lumen tube placement with the patient in the supine position without a headrest minimizes displacement during lateral positioning

Double-lumen tube placement with the patient in the supine position without a headrest minimizes displacement during lateral positioning

New landmarks improve the positioning of the left Broncho-Cath™ double-lumen tube-comparison with the classic technique

Lung separation and the difficult airway

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