Abstract
Background Tube size selection is critical in ventilating patients' lungs using double-lumen endobronchial tubes (DLTs). Little information about relevant parameters is readily available from manufacturers. The aim of this study is to provide reference data for relevant dimensions of conventionally available DLTs. Methods In this study in a benchmark in vitro setup, several dimensional parameters of four sizes of left-sided double-lumen endobronchial tubes from six different manufacturers were assessed, such as distances and diameters of tube shaft, cuff lengths, and diameters as well the angle at the tip. Results Endobronchial tubes of ostensibly the same size revealed wide variation in measured parameters between brands from different manufacturers. In some parameters, there was an overlap between different sizes from the same manufacturer, i.e., diameters and distances did not increase with increasing nominal endobronchial tube size. The information about dimensions of endobronchial tubes provided by manufacturers' leaflets is insufficient. Conclusions Endobronchial tube size selection carries unnecessary uncertainty because clinically relevant parameters are unknown and vary considerably between different manufacturers.
Highlights
One-lung ventilation for thoracic surgery and occasionally in critical care medicine represents one of the most challenging airway and ventilation management tasks for anesthesiologists and/or intensivists [1, 2]. e bronchial blockers and double-lumen endobronchial tubes (DLTs) are the two main techniques for isolation of the lungs and onelung ventilation, with the Double-lumen endobronchial tube Fr (DLT) used more frequently [3,4,5]
Irrespective of the decision to use a left-sided or right-sided DLT, choosing the appropriate size is critical. e consequences of inserting/using an inappropriately sized DLT can result in significant clinical problems, such as difficulty in ventilating the lungs’ potential difficulties in letting the lung collapse, the need for tube exchange with reintubation, severe injuries to the airway, impaired surgical conditions, or even inability to perform the planned surgical procedure [2, 6,7,8,9]
There are methods incorporating actual patient information from radiological imaging as tracheal width or the size of the left main-stem bronchus [2, 11,12,13,14,15,16]. e latter has become more relevant in recent years, as the majority of patients planned for thoracic surgery with one-lung ventilation have usually undergone preoperative computed tomography (CT) imaging of their lungs and trachea-bronchial tree
Summary
One-lung ventilation for thoracic surgery and occasionally in critical care medicine represents one of the most challenging airway and ventilation management tasks for anesthesiologists and/or intensivists [1, 2]. e bronchial blockers and double-lumen endobronchial tubes (DLTs) are the two main techniques for isolation of the lungs and onelung ventilation, with the DLT used more frequently [3,4,5]. E bronchial blockers and double-lumen endobronchial tubes (DLTs) are the two main techniques for isolation of the lungs and onelung ventilation, with the DLT used more frequently [3,4,5]. Tube size selection is critical in ventilating patients’ lungs using double-lumen endobronchial tubes (DLTs). In this study in a benchmark in vitro setup, several dimensional parameters of four sizes of left-sided double-lumen endobronchial tubes from six different manufacturers were assessed, such as distances and diameters of tube shaft, cuff lengths, and diameters as well the angle at the tip. Endobronchial tube size selection carries unnecessary uncertainty because clinically relevant parameters are unknown and vary considerably between different manufacturers
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