Tracheal rupture with disposable polyvinylchloride double-lumen endotracheal tubes

Abstract

In 1949, Carlens first introduced the concept of double-lumen endobronchial tubes (DLT) and one-lung ventilation (OLV). 1 Since then, DLTs have been widely accepted as a safe and technically easy method to improve exposure, thereby shortening the duration of the operation in a variety of thoracic surgical procedures. Until recently, there were few reports concerning problems that could be directly ascribed to the DLTs. However, there have been an increasing number of publications documenting tracheobronchial tears when the standard red rubber Robertshaw, Carlens, and White DLTs have been used. 3–8 The newer variety of disposable polyvinylchloride (PVC) DLTs has been developed and presented as a safer and more convenient alternative. 9–11 However, it has been noted that PVC DLTs are prone to some of the same problems associated with the red rubber tubes. 12–14 Two cases of tracheal rupture associated with the use of PVC DLTs are presented and the authors make some suggestions that might increase the margin of safety when using these tubes.