The effects of endobronchial cuff inflation on double-lumen endobronchial tube movement after lateral decubitus positioning

Desiderio, Dawn P.; Burt, Michael; Kolker, Anne C.; Fischer, Mary; Reinsel, Ruth A.; Wilson, Roger S.

doi:10.1016/s1053-0770(97)90011-2

Cited by 68 publications

(52 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5 The difference between tracheal and bronchial displacements during lateral positioning was inconsistent in the previous studies. 5,6 In Yoon et al's study, 5 the tracheal displacement was more prominent than the bronchial displacement, whereas there was no difference in the two types of displacements in the other study. 6 Further investigation may be needed with regard to this matter.…”

Section: Discussionmentioning

confidence: 80%

“…Furthermore, in order to make DLT displacement less risky, we recommend positioning the proximal margin of the DLT bronchial cuff 5-10 mm deeper than the carinal level before lateral positioning. [5][6][7] During direct laryngoscopy in the sniffing position, the patient's head is usually elevated by supporting the occiput on a headrest about 10 cm high. 12 In our study, the 9 cm high headrest was used because it provided better laryngoscopic views than 3 cm or 6 cm high headrests.…”

Section: Discussionmentioning

confidence: 99%

“…12 In our study, the 9 cm high headrest was used because it provided better laryngoscopic views than 3 cm or 6 cm high headrests. 13 Desiderio et al 6 reported that the Sher-I-Broth TM DLT (Sheridan, Argyle, NY, USA) was displaced proximally about 9.2 mm in both Values are expressed as mean (standard deviation), (range), or number of patients. There were no differences in all the parameters between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…Les distances se´parant l'origine de la trache´e de la grande care`ne et de l'origine de la bronche souche jusqu'a`la care`ne de la bronche gauche ont e´te´mesure´es al 'aide d'un bronchoscope chez les patients en decubitus dorsal puis en decubitus lateral. Résultats Le de´placement des DLT (moyenne [e´cart-type]) au cours de la mise en decubitus late´ral a e´te´plus important dans le groupe avec appuie-teˆte que dans le groupe sans appuie-teˆte (respectivement 12,3 [5,6] mm contre 6,8 [5,5] mm dans la trache´e et 11,6 [6,7] mm contre 6,0 [4,6] mm dans la bronche; P \ 0,001). L'incidence d'un de´placement significatif, de´fini comme e´tant [ 10 mm par rapport a`la position initiale, a e´te´supe´rieure dans le groupe avec appuie-teˆte par rapport au groupe sans appuie-teˆte (respectivement, 64 % contre 28 % pour la trache´e et 58 % contre 20 % pour la bronche; P \ 0,001).…”

Section: Résuméunclassified

“…[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. Tracheal intubation is most likely performed under direct laryngoscopy with the patient in a supine position on a headrest.…”

Section: Résumémentioning

confidence: 99%

See 4 more Smart Citations

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

View full text Add to dashboard Cite

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.

show abstract