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

Brodsky, Jay B.; Lemmens, Harry J. M.

doi:10.1016/j.jclinane.2004.07.008

Cited by 73 publications

(50 citation statements)

References 12 publications

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“…The diameter of the trachea and the left main bronchus can also be used to predict the size of the DLT accurately [4,7,13,16]; therefore, the present study uses the diameter of the trachea and the left main bronchus to determine the size of the DLT. As applying this result to short patients has low clinical relevance, further prospective studies are needed.…”

Section: Discussionmentioning

confidence: 99%

Airway dimensions and margin of safety with the left-sided double-lumen tube in patients of a short stature

Lee¹,

Lee²,

Choi³

et al. 2015

Anesth Pain Med

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:The size and depth of the double-lumen tube (DLT) are important for one-lung ventilation (OLV). In patients of a short stature, it is difficult to perform OLV successfully. We designed this study to evaluate the dimensions and margin of safety of the left main bronchi in patients of a short stature for appropriate OLV. Methods: Chest computed tomography (CT) scans of 241 patients (22 male, 219 female) of a short stature (height below 155 cm) were analyzed retrospectively. The diameters of the trachea (DT), the right and left main bronchi (DR and DL), and the lengths of the right and left main bronchi (LR and LL) were measured at the coronal section of the chest CT scans using a picture archiving communication system program. Results: There were no significant correlations between the heights and lengths of the right and left main bronchi. In addition, the ages and weights of the patients showed no significant correlations with the airway dimensions. The lengths of the bronchial lumen of the left-sided Mallinckrodt DLT show variations of 3 to 5.5 mm with tubes of identical sizes. The margin of safety is 13.8 ± 4.1 mm assuming that appropriately sized DLTs are inserted. Conclusions: For successful and safe OLV in patients of a short stature, anesthesiologists should consider the length of the main bronchus and the actual length of the bronchial lumen of the DLT.

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Section: Discussionmentioning

confidence: 99%

Airway dimensions and margin of safety with the left-sided double-lumen tube in patients of a short stature

Lee¹,

Lee²,

Choi³

et al. 2015

Anesth Pain Med

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“…Furthermore, one size of EZB will fit almost all adult patients, whereas selecting the best size for a DLT is rather complicated. 10,11 The cuff pressure of the EZB at adequate cuff volume is high and could be responsible for mucosal injury at the mainstem bronchi.…”

Section: Efficiency Efficacy and Safety Of Ez-blocker Compared Withmentioning

confidence: 99%

“…If not clearly visible on radiography, the tracheal width at the level of the clavicles was measured and the following formula was used 10 : left mainstem bronchus diameter (mm) = (0.45) (tracheal width [mm]) + 3.3 mm. If the diameter of the left mainstem bronchus was 12, 13, or greater than 14 mm, a DLT size 35-, 37/39-, and 41-French, respectively, was chosen.…”

Section: A Comparison Between Dlt and Ezbmentioning

confidence: 99%

Efficiency, Efficacy, and Safety of EZ-Blocker Compared with Left-sided Double-lumen Tube for One-lung Ventilation

Mourisse

Liesveld

Verhagen³

et al. 2013

Anesthesiology

122

119

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Background: Double-lumen tubes (DLTs) or bronchial blockers are commonly used for one-lung ventilation. DLTs are sometimes difficult or even impossible to introduce, and the incidence of postoperative hoarseness and airway injuries is higher. Bronchial blockers are more difficult to position and need more frequent intraoperative repositioning. The design of a Y-shaped bronchial blocker, the EZ-Blocker (Teleflex Life Sciences Ltd., Athlone, Ireland) (EZB), combines some advantages of both techniques. The objective of this study was to assess whether EZB performs clinically better than left-sided DLTs (Broncho-cath; Mallinckrodt, Athlone, Ireland) without causing more injury. Primary outcome was the frequency of initial malpositions. Methods: Eligible patients were adults scheduled for surgery requiring one-lung ventilation who met criteria for placement of both devices. In this parallel trial, 100 consecutive and blinded patients were assigned randomly using a computer-generated list to two groups. The incidence of malposition and ease and time of placement were recorded. Blinded assessors investigated quality of lung deflation, postoperative complaints, and damage to the airway.Results: Placement of a DLT was unsuccessful twice. The incidence of initial malposition was high and comparable between EZBs (37 of 50) and DLTs (42 of 49) (P = 0.212). Placing single-lumen tubes and EZBs took more time but was rated easier. Quality of lung deflation was comparable. Fewer patients in the EZB group complained of sore throat at day 1. There was a higher incidence of tracheal hematoma and redness and bronchial hematoma in the DLT group. Conclusions:The EZB is an efficient and effective device for one-lung ventilation and causes less injury and sore throat than a DLT.

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“…If the ETT is too small, it will be easily dislocated with malposition [2][3][4]. Brodsky et al found a direct correlation between tracheal and bronchial widths, and that measurement of the tracheal width from a chest radiograph was a useful guide in determining which LDLT size to select [5][6][7]. The trachea, because of its relatively superficial position, is easily visible by ultrasonography [8].…”

Section: Introductionmentioning

confidence: 99%

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

Šustić¹,

Miletić²,

Protić³

et al. 2008

Journal of Clinical Anesthesia

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

Cited by 73 publications

References 12 publications

Airway dimensions and margin of safety with the left-sided double-lumen tube in patients of a short stature

Airway dimensions and margin of safety with the left-sided double-lumen tube in patients of a short stature

Efficiency, Efficacy, and Safety of EZ-Blocker Compared with Left-sided Double-lumen Tube for One-lung Ventilation

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

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