scholarly journals Double lumen tube location predicts tube malposition and hypoxaemia during one lung ventilation

2004 ◽  
Vol 92 (2) ◽  
pp. 195-201 ◽  
Author(s):  
S Inoue ◽  
N Nishimine ◽  
K Kitaguchi ◽  
H Furuya ◽  
S Taniguchi
Keyword(s):  
Lung Ventilation ◽  
Double Lumen Tube ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lumen Tube ◽  
Tube Malposition

The Comparative Study of the Single-lumen Tube and Double-lumen Tube in the Blood Gas Analysis for One-lung Ventilation

1994 ◽  
Vol 27 (4) ◽  
pp. 381
Author(s):  
Su Won Kim ◽  
Byung Young Kim ◽  
Myoung Hoon Kong ◽  
Hae Ja Lim ◽  
Byung Kook Chae ◽  
...  
Keyword(s):  
Lung Ventilation ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Double Lumen Tube ◽  
Blood Gas ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lumen Tube ◽  
Single Lumen ◽  
The Comparative Study

Iatrogenic rupture of the trachea caused by double Lumen tube intubation

Open Medicine ◽  
2010 ◽  
Vol 5 (6) ◽  
pp. 737-741 ◽  
Author(s):  
Iztok Potocnik ◽  
Andreas Kupsch ◽  
Vesna Jankovic
Keyword(s):  
Fiber Optic ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Tracheal Rupture ◽  
Lumen Tube ◽  
Video Assisted ◽  
Tracheobronchial System ◽  
Hazardous Procedure

AbstractAcute injuries of the tracheobronchial system are rare and life-threatening situations. Tracheal rupture most commonly occurs after blunt trauma to the chest. It is a rare but most concerning immediate complication of intubation. One-lung ventilation is required in lung surgery. Video assisted thoracoscopic procedures are an absolute indication for one-lung intubation. The double-lumen tube is the mainstay of one lung ventilation. Due to their larger size and rigidity, double lumen tubes are more difficult to insert, and complications are more common than with single lumen tubes. Opinions about the need for checking routinely the position of a double lumen tube by fiber optic bronchoscopy directly after intubation are divided. A 69-year-old woman with epidermoid lung carcinoma was scheduled for video assisted thoracoscopic left upper pulmonary lobectomy under general anaesthesia. The patient was prepared for the operation and itubated with the Carlens double lumen tube as usual. On introducing the camera into the thoracic cavity, the surgeon noted that the lungs were not completely collapsed. During blind adjustment the position of the tube the trachea was ruptured. The right-sided thoracotomy was performed and closed the greater part of the tracheal laceration. Only its upper 1.5-cm segment was surgically inaccessible because of the anatomical situation and thus remained unsutured. The patient received antibiotics, continuous airway humidification, analgesia with piritramide, and chest physiotherapy. She had no complications. In the literature, opinions about checking routinely the position of a double lumen tube by fiber optic bronchoscopy are divided.. Possibly, the very serious complication encountered in our patient could have been avoided, had the tube position been checked by bronchoscopy. The treatment strategy for post-intubation tracheal rupture depends on the size and location of the rupture, its clinical presentation, and the overall condition of the patient). Early surgical repair is the treatment of choice for most patients when a transmural tear with a length exceeding 2 cm. In our the combination of surgical and conservative treatment was performed. The uppermost part of the tear could not be sutured because of the anatomical situation, and so about 1.5 cm of the trachea remained open. The case is interesting from many perspectives. It shows that intubation with a Carlens tube is a potentially hazardous procedure, which should be performed only by experienced anaesthesiologists. Furthermore, our case report underscores the importance of checking routinely the position of a double lumen tube by fiber optic bronchoscopy. It provides evidence that minor tracheal lacerations can be successfully managed by conservative measures.

scholarly journals Difficulty Intubating a Double-Lumen Tube due to a Tracheal Bronchus: A Case Report

2021 ◽  
Author(s):  
Wenzhu Wang ◽  
Ji Li ◽  
Jian Liu ◽  
Chengwei Song ◽  
ya-nan Zhang
Keyword(s):  
Left Lung ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
Bronchial Blocker ◽  
Tracheal Bronchus ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lumen Tube ◽  
The One ◽  
The Right

Abstract Background: Intubation difficulties, hypoxemia, inability to perform a one-lung ventilation, and high airway pressure often occur during double-lumen tube intubation. Tracheal bronchus is a very rare and difficult to find reason. We present a case of tracheal bronchus accidentally discovered during double-lumen tube intubation in a patient undergoing thoracic surgery. We are the first one to summarize the one-lung ventilation strategy for patients with tracheal bronchus. Case Presentation: A 53-year-old man underwent a scheduled thoracoscopic left upper lobectomy. After two unsuccessful attempts to pass the right-sided double-lumen tube through the right mainstem bronchus, fiberoptic bronchoscopy revealed an aberrant tracheal bronchus with an incidence of 0.1%–3%. Finally we used a left-sided DLT to ventilate the right lung. The patient had no airway complications and was discharged 7 days after the operation.Conclusions: This case serves to remind us that preoperative visits must be thorough and careful. Although a computed tomography chest examination was performed before surgery, we just looked at the inspection report and did not look at the images. We also reviewed relevant literature and summarized the one-lung ventilation strategies for patients with tracheal bronchus. For left-lung ventilation, either a left-sided double-lumen tube or a combination of a bronchial blocker and Fogarty artery embolization catheter can be used. For right-lung ventilation, a bronchial blocker or a left-sided double-lumen tube is a good choice.

Airway Injuries after One-lung Ventilation: A Comparison between Double-lumen Tube and Endobronchial Blocker

2006 ◽  
Vol 105 (3) ◽  
pp. 471-477 ◽  
Author(s):  
Heike Knoll ◽  
Stephan Ziegeler ◽  
Jan-Uwe Schreiber ◽  
Heiko Buchinger ◽  
Patric Bialas ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Sore Throat ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
Cumulative Number ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lumen Tube ◽  
Endobronchial Blocker ◽  
The Impact

Background Vocal cord injuries, postoperative hoarseness, and sore throat are common complications after general anesthesia. One-lung ventilation can be achieved via two techniques: double-lumen endotracheal tube or endobronchial blocker such as the Arndt blocker. The current study was designed to assess the impact of these techniques for one-lung ventilation on the incidence and severity of postoperative hoarseness, vocal cord lesions, and sore throat. Methods In this prospective trial, 60 patients were randomly assigned to two groups. One-lung ventilation was achieved with either an endobronchial blocker (blocker group) or a double-lumen-tube (double-lumen group). Postoperative hoarseness and sore throat were assessed at 24, 48, and 72 h after surgery. Bronchial injuries and vocal cord lesions were examined by bronchoscopy immediately after surgery. Results In 56 included patients, postoperative hoarseness occurred significantly more frequently in the double-lumen group compared with the blocker group: 44% versus 17%, respectively (P = 0.046). Similar findings were observed for vocal cord lesions: 44% versus 17%, respectively (P = 0.046). The incidence of bronchial injuries was comparable between groups (P = 0.540). Cumulative number of days with hoarseness and sore throat were significantly increased in the double-lumen group compared with the blocker group (P < 0.01). No major complications such as bronchial ruptures were observed. Conclusions Clinicians should be aware of an increased incidence of minor airway injuries that may impair patient satisfaction when using a double-lumen tube instead of an endobronchial blocker for one-lung ventilation.

scholarly journals Application of a Double-lumen Tube for One-lung Ventilation in Patients With Anticipated Difficult Airway

2010 ◽  
Vol 48 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Chih-Kai Shih ◽  
Yi-Wei Kuo ◽  
I-Chen Lu ◽  
Hong-Te Hsu ◽  
Koung-Shing Chu ◽  
...  
Keyword(s):  
Difficult Airway ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
One Lung Ventilation ◽  
Double Lumen ◽  
Lumen Tube
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