Placement of left double-lumen endobronchial tubes with or without a stylet

Lieberman, Dianne; Littleford, Judith; Horan, Tom; Unruh, Helmut

doi:10.1007/bf03011741

Cited by 40 publications

(19 citation statements)

References 14 publications

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“…This is in agreement with other investigators. 2,3,15 In four cases, the left-sided DLT was positioned in the right mainstem bronchus. In one of these patients, it was not possible to correct the malposition and therefore this patient was excluded from further analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies report the incidence of malpositioning of left-sided DLTs to range from 10-83% (weighted mean, 53%). [1][2][3][4][5]15 One effect of the higher than anticipated incidence of malposition of DLTs is that the number of patients enrolled is generous. Our rather stringent definition of device malposition may be responsible for the high rate of malpositions we report.…”

Section: Discussionmentioning

confidence: 99%

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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

124

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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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

124

119

View full text Add to dashboard Cite

show abstract

“…It has been reported that using the retaining stylet during the entire intubation procedure allows more accurate placement of the endobronchial tube without increasing the incidence of tracheobronchial mucosa injury [14]. A single-lumen endotracheal tube usually tends to enter the right main bronchus.…”

Section: Discussionmentioning

confidence: 99%

Facilitation of alternative one-lung and two-lung ventilation by use of an endotracheal tube exchanger for pediatric empyema during video-assisted thoracoscopy

Chung

et al. 2004

Surg Endosc

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“…Placing the fiberoptic bronchoscope in the left main bronchus was not difficult, but when we pushed the tube, the left bronchial tip slid into the right main bronchus. We tried using another method; the stylet was not removed just after the tip of the tube passed the vocal cord and was retained for the entire intubation procedure [4]. However, it could not enter the left main bronchus.…”

Section: Case Reportmentioning

confidence: 99%

Tracheal laceration during intubation of a double-lumen tube and intraoperative fiberoptic bronchoscopic evaluation through an LMA in the lateral position -A case report-

Kim

Lim

Bahk

2011

Korean J Anesthesiol

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A 76-year-old, 148-cm woman was scheduled for right upper lobectomy. A 32 Fr left-sided double lumen tube was placed using a conventional technique. Despite several attempts under fiberoptic bronchoscope-guidance, we could not locate the double lumen tube properly. We thus decided to proceed with the bronchial tube in the right mainstem bronchus. During surgery, 8-cm-long laceration was noted on the posterolateral side of the trachea. To check the possibility of laceration of the proximal trachea, the double lumen tube was changed to an LMA for use as a conduit for fiberoptic bronchoscopic evaluation in the lateral position. A plain endotracheal tube with the cuff modified and collapsed was re-intubated after evaluation. And then she was transferred to SICU.

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Placement of left double-lumen endobronchial tubes with or without a stylet

Cited by 40 publications

References 14 publications

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

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

Facilitation of alternative one-lung and two-lung ventilation by use of an endotracheal tube exchanger for pediatric empyema during video-assisted thoracoscopy

Tracheal laceration during intubation of a double-lumen tube and intraoperative fiberoptic bronchoscopic evaluation through an LMA in the lateral position -A case report-

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