Comparison of displacement of polyvinyl chloride and silicone leftsided double-lumen tubes during lateral positioning

Kwon, Nyeong Keon; Jung, Sung Mee; Park, Sang-Jin; Han, Young Hwan

doi:10.4097/kja.d.18.00012

Cited by 9 publications

(4 citation statements)

References 11 publications

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“…Another structural feature of the Human Broncho is that it has a shorter and more distally located bronchial cuff compared to the Broncho-Cath, which reduces the risk of left upper lobe bronchus obstruction, increasing the margin of safety. 13 It also makes the gaps between the upper edge of the bronchial cuff and the tracheal lumen opening (distal and proximal end) denoted as (a) and (b) longer in the Human Broncho (3.4, 4.0 cm) than Broncho-Cath (1.8, 2.9 cm; Figure 4A and B ). Moreover, the distance from the upper edge of the bronchial cuff to the end of the tracheal segment denoted as orotracheal segment is longer in the Human Broncho (33.5 cm) than the Broncho-Cath (30 cm; Figure 5 ).…”

Section: Discussionmentioning

confidence: 99%

Use of the Human Broncho® Double-Lumen Tube in a Tracheal Bronchus Patient After Failed Lung Isolation with a Broncho-Cath™: A Case Report

Byun¹,

Kim²

2021

IMCRJ

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Airway management for one-lung ventilation may be challenging for anesthesiologists depending on the location of the tracheal bronchus orifice and possible anatomical distortions. Polyvinyl chloride double-lumen tube Broncho-Cath™ has been successfully used for one-lung ventilation in most cases of tracheal bronchus arising within 2 cm above the carina. However, there have been reports of occasional failure. A 78-year-old male patient diagnosed with secondary pneumothorax was scheduled for video-assisted thoracic surgery, and the tracheal bronchus originating 1.9 cm above the carina was shown in the preoperative chest computed tomography. Although a left-sided Broncho-Cath was initially placed, one-lung ventilation could not be achieved. Under bronchoscopy view through the tracheal lumen, the tracheal bronchus orifice was found to be partially obstructed. Furthermore, the bronchial cuff was herniated from the left main bronchus, leading to a failure of one-lung ventilation. The Broncho-Cath was replaced with a silicone double-lumen tube Human Broncho ® , which has more flexible bronchial segment and an increased marginal gap between the bronchial cuff and the tracheal lumen opening. The Human Broncho was successfully placed in an optimal position within the left main bronchus without blocking the tracheal bronchus orifice, thereby achieving the successful one-lung ventilation. The structurally unique Human Broncho may be considered as an alternative option in thoracic surgery of tracheal bronchus patients if lung isolation cannot be achieved with the Broncho-Cath.

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Section: Discussionmentioning

confidence: 99%

Use of the Human Broncho® Double-Lumen Tube in a Tracheal Bronchus Patient After Failed Lung Isolation with a Broncho-Cath™: A Case Report

Byun¹,

Kim²

2021

IMCRJ

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“…Different studies have different definitions of DLT malposition, it can be defined as tube position that if not corrected might lead to clinical problems, such as defined by Campos et al [10] as a bronchial cuff more than halfway out or not visible in the entrance of mainstem bronchus, or in opposite bronchus, or unable to distinguish tracheal/bronchial anatomy. Malposition also can be defined as a deviation from the optimal placement to provide an easy quantitative measure, and the deviation mainly focused on 0.5 cm or 1.0 cm [6,[11][12][13][14].…”

Section: The Definitions Of Dlt Malpositionmentioning

confidence: 99%

Recent Advances in Double-Lumen Tube Malposition in Thoracic Surgery: A Bibliometric Analysis and Narrative Literature Review

Zhang¹,

Wang²,

Wei³

et al. 2022

Preprint

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The thoracic surgery has increased drastically in recent years, especially in the light of the severe outbreak of 2019 novel coronavirus disease (COVID-19). Routine “passive” computed tomography of the chest screening of inpatients detects some pulmonary disease requiring thoracic surgeries timely. As an essential equipment for thoracic anesthesia, the double-lumen tube (DLT) in precise position is particularly important for anesthesia and surgery. With the continuous up-grading of the DLTs and the widespread use of the fiberoptic bronchoscopy (FOB), the position of DLT in thoracic surgery is gradually becoming more stable and easier to observe or adjust. However, for reasons such as transferring the patient to the lateral position, the DLT malposition still occurs in thoracic surgery, leading to lung isolation failure and hypoxemia during one-lung ventilation (OLV). Recently some innovative DLTs based on traditional have shown good results in reducing the incidence of DLT malposition, and some studies also found a lower malposition rate through improved intervention methods. This review aims to discuss and summarize the recent rates of left-sided DLT malposition, the reasons and effects of malposition, and to sum up current methods of reducing DLT malposition as well as prospects for possible approaches. Meanwhile, we use bibliometric analysis to summarize the research trends and hot spots of the DLT research.

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“…Different studies have different definitions of DLT malposition, it can be defined as tube position that if not corrected might lead to clinical problems, such as defined by Campos et al (10) as a bronchial cuff more than halfway out or not visible in the entrance of mainstem bronchus, or in opposite bronchus, or unable to distinguish tracheal/bronchial anatomy. Malposition also can be defined as a deviation from the optimal placement to provide an easy quantitative measure, and the deviation mainly focused on 0.5 cm or 1.0 cm (6,(11)(12)(13)(14). Specifically, Inoue et al (11) defined DLT malposition as the tube must be pushed in or out more than 1.0 cm to correct its position, since the authors indicated that Japanese patients were small and a 1.0 cm deviation might be critical.…”

Section: The Definitions Of Dlt Malpositionmentioning

confidence: 99%

Recent Advances in Double-Lumen Tube Malposition in Thoracic Surgery: A Bibliometric Analysis and Narrative Literature Review

Zhang¹,

Wang²,

Wei³

et al. 2022

Preprint

View full text Add to dashboard Cite

The thoracic surgery has increased drastically in recent years, especially in the light of the severe outbreak of 2019 novel coronavirus disease (COVID-19). Routine “passive” chest computed tomography (CT) screening of inpatients detects some pulmonary diseases requiring thoracic surgeries timely. As an essential device for thoracic anesthesia, the double-lumen tube (DLT) is particularly important for anesthesia and surgery. With the continuous upgrading of the DLTs and the widespread use of the fiberoptic bronchoscopy (FOB), the position of DLT in thoracic surgery is gradually becoming more stable and easier to observe or adjust. However, the DLT malposition still occurs during transferring patients from supine to lateral position in thoracic surgery, which leads to lung isolation failure and hypoxemia during one-lung ventilation (OLV). Recently some innovative DLTs or improved intervention methods have shown good results in reducing the incidence of DLT malposition. This review aims to summarize the recent studies of the incidence of left-sided DLT malposition, the reasons and effects of malposition, and summarize current methods for reducing DLT malposition and prospects for possible approaches. Meanwhile, we use bibliometric analysis to summarize the research trends and hot spots of the DLT research.

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Comparison of displacement of polyvinyl chloride and silicone leftsided double-lumen tubes during lateral positioning

Abstract: Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.

Cited by 9 publications

References 11 publications

Use of the Human Broncho® Double-Lumen Tube in a Tracheal Bronchus Patient After Failed Lung Isolation with a Broncho-Cath™: A Case Report

Use of the Human Broncho® Double-Lumen Tube in a Tracheal Bronchus Patient After Failed Lung Isolation with a Broncho-Cath™: A Case Report

Recent Advances in Double-Lumen Tube Malposition in Thoracic Surgery: A Bibliometric Analysis and Narrative Literature Review

Recent Advances in Double-Lumen Tube Malposition in Thoracic Surgery: A Bibliometric Analysis and Narrative Literature Review

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