One lung ventilation using double-lumen tubes: Initial experience from Lagos, Nigeria.

Abstract

One lung ventilation (OLV) is a technique routinely used in thoracic anesthesia to facilitate thoracic surgery. Double-lumen tubes (DLT) remain the most popular and reliable choice for one lung ventilation especially in adult patients though use in Nigeria is limited. This study aimed to describe the experience in our institution with the use of double-lumen tubes for one lung ventilation. This was a retrospective cross-sectional study conducted on all patients who had double-lumen tube intubations for one lung ventilation between March 2008 and Feb 2013. A total of 55 patients (27 males and 28 females, with a mean age of 39.6 ± 15.7 years) had left double-lumen tube intubations during the period. There were 30 left-sided (54.5%) and 25 right-sided (45.5%) surgical procedures performed. Tube position was verified by flexible bronchoscopy in 50 patients (91.9%) and by chest auscultation in 5 patients (9.1%) with satisfactory collapse in all but one of the procedures. The major surgical indications for one lung ventilation were Video-assisted Thoracic Surgery (VATS) in 22 patients (40%) and Heller's cardiomyotomy in 17 (30.9%). There were no mortalities and all patients had a complete recovery with no sequelae attributable to double-lumen tube use or one lung ventilation. One lung ventilation is an integral component of modern anesthetic practice. It can be safely practiced in Nigeria with appropriate equipment and expertise. The use of DLT for OLV to enhance thoracic anesthetic practice should be encouraged in other Nigerian institutions.