Displacement of the double-lumen endobronchial tube can be detected by bronchial cuff pressure change.

Abstract

We measured the bronchial cuff pressure of left-sided double-lumen endobronchial tubes (DLTs) in 54 patients to confirm the effect of DLT displacement on cuff pressure. After positioning the cephalad surface of the bronchial cuff of the DLT 2.5 cm distal to the carina (23 patients in the first part of the study) or just below the carina (23 patients in the second part), the cuff was withdrawn in 0.5-cm steps during right-sided, one-lung ventilation. The bronchial cuff pressure was measured, and the capnogram and pressure-volume loop, displayed by a side-stream spirometer, was evaluated. After positioning the cephalad surface of the bronchial cuff just below the carina (eight patients in the third part), bronchial cuff pressure was measured while confirming the position of the bronchial cuff during the 30 min of the operative procedure. The bronchial cuff pressure decreased significantly by 28.4 cm H2O (P < 0.01) and 21.3 cm H2O (P < 0.01) in the first and second parts, respectively, before the pressure-volume loop or the capnogram changed. The bronchial cuff pressure in the third part showed no significant change. We conclude that bronchial cuff pressure monitoring was very helpful in detecting displacement of the DLT during right-sided, one-lung ventilation.