A logical approach to the selection and insertion of double-lumen tubes

Current Opinion in Anaesthesiology
W J Russell

Abstract

There has been a progressive evolution in double-lumen tubes to separate the right and left lungs. The appreciation of the anatomical advantage of the longer left main bronchus has directed anesthetists to prefer a left tube if possible for lung separation. Understanding the dimensions of the tube as well as the variations in the left main bronchus has improved the process of selection and insertion of the double-lumen tubes for lung isolation. Early work focused on the anatomy of the longer left main bronchus. More recent work looked at the tube. This showed that tubes of the same nominal French size were substantially different in the size of the bronchial tube diameter and length. The proposed International Standards Organization standard will more accurately identify tube dimensions. These factors must be considered when selecting a tube for lung separation. Measurement of patient's airway dimensions combined with knowledge of the dimensions of the double-lumen (tracheobronchial) tube plays an important role in lung separation.

References

Feb 1, 1992·Anaesthesia and Intensive Care·W J Russell
Nov 1, 1987·Anesthesiology·J L BenumofJ Keating
Apr 1, 1995·Journal of Cardiothoracic and Vascular Anesthesia·M S HannallahU E Ruttimann
Oct 1, 1993·Journal of Cardiothoracic and Vascular Anesthesia·J L Benumof
Oct 1, 1993·Journal of Cardiothoracic and Vascular Anesthesia·W E Hurford, P H Alfille
Jan 15, 2004·British Journal of Anaesthesia·S InoueS Taniguchi
Jul 13, 2004·British Journal of Anaesthesia·A H SeymourR J McKenzie

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Citations

Jul 15, 2009·General Thoracic and Cardiovascular Surgery·Tadashi Akiba
Dec 17, 2009·British Journal of Anaesthesia·J B Brodsky
Jun 14, 2016·Journal of Clinical Anesthesia·Gianluca ZaniAgnoletti Vanni
May 11, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Robert M DiBlasiMargaret Rosenfeld
Jun 10, 2021·Türk göğüs kalp damar cerrahisi dergisi·Atakan ErkılınçMustafa Emre Gürcü

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