Practice patterns in choice of left double-lumen tube size for thoracic surgery Journal Article
| Authors: | Amar, D.; Desiderio, D. P.; Heerdt, P. M.; Kolker, A. C.; Zhang, H.; Thaler, H. T. |
| Article Title: | Practice patterns in choice of left double-lumen tube size for thoracic surgery |
| Abstract: | BACKGROUND: Some anesthesiologists choose smaller than body size-appropriate left sided double-lumen tubes (DLTs) ("down-size") for lung isolation in an attempt to limit the risk of airway trauma. There are few data on the effects of DLT size on intraoperative outcome measures. METHODS: In 300 adults undergoing thoracic surgery requiring lung isolation, we conducted a prospective pilot study to evaluate whether the use of 35 FR DLT, regardless of gender and/or height (care standard of two investigators), was associated with a similar incidence of intraoperative hypoxemia, lung isolation failure, or need for DLT repositioning during surgery (noninferiority) than with the conventional goal of inserting the largest possible DLT (care standard of two other investigators). DLT insertion position was immediately confirmed with fiberoptic bronchoscopy after direct laryngoscopic placement and after lateral positioning. RESULTS: The combined incidence of transient hypoxemia, inadequate lung isolation, or need for DLT repositioning during surgery did not differ among patients receiving 35, 37, or 39 FR DLT, regardless of gender or height. Despite the high frequency of 35 FR DLT use, 2% of patients required further down-sizing due to the inability to introduce the DLT into the left mainstem bronchus or when no inflation of the bronchial cuff was needed for lung isolation. CONCLUSIONS: Under the conditions of this pilot study, the use of smaller than conventionally sized DLT was not associated with any differences in clinical intraoperative outcomes. © 2008 by International Anesthesia Research Society. |
| Keywords: | adult; controlled study; aged; middle aged; prospective study; prospective studies; incidence; postoperative complication; professional practice; pilot study; pilot projects; bronchoscopy; sex difference; fiber optics; equipment design; hypoxemia; thorax surgery; choice behavior; peroperative care; thoracic surgical procedures; intraoperative complications; double lumen tube; height; intubation, intratracheal |
| Journal Title: | Anesthesia and Analgesia |
| Volume: | 106 |
| Issue: | 2 |
| ISSN: | 0003-2999 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2008-02-01 |
| Start Page: | 379 |
| End Page: | 383 |
| Language: | English |
| DOI: | 10.1213/ane.0b013e3181602e41 |
| PUBMED: | 18227288 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 7" - "Export Date: 17 November 2011" - "CODEN: AACRA" - "Source: Scopus" |
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