Document Detail


Predicting the depth of insertion of left-sided double-lumen endobronchial tubes.
MedLine Citation:
PMID:  12154425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To analyze the parameters that predict the depth of insertion of a left-sided double-lumen tube (DLT) and to assess the accuracy of the parameters after intubation. DESIGN: Prospective. SETTING: Tertiary-care hospital. PARTICIPANTS: Patients undergoing 1-lung ventilation for thoracic surgery (n = 240). INTERVENTIONS: In the first 121 patients, the ideal depth of insertion was verified using fiberoptic bronchoscopy in the lateral position. Multiple regression analysis was used to find the correlation of this depth of insertion to the patients' height, weight, age, and the clavicular-to-carinal distance of the trachea measured from the chest radiograph. Another 119 patients were studied in whom the DLT was inserted blindly using the best regression line. The accuracy of the technique was assessed by fiberoptic bronchoscopy. MEASUREMENTS AND MAIN RESULTS: The depth of DLT insertion correlated significantly (p < 0.05) only with the height and clavicular-to-carinal distance of the trachea of the patients with the best regression line: Depth of insertion (cm) = 0.75 x clavicular-to-carinal distance of trachea (cm) + 0.112 x height (cm) + 6 with R(2) = 0.62 and p < 0.001. Using this best regression line, the DLT was placed in an acceptable position in 93 patients in the lateral position (positive predictive value of 78.2%) without further intraoperative adjustments. CONCLUSION: The ideal depth of insertion of the left-sided DLT correlated significantly with patients' height and clavicular-to-carinal distance of the trachea. The best regression line enabled the left-sided DLT to be placed in an acceptable position without complications nearly 80% of the time.
Authors:
Mark Yew-Hoong Chow; Meng-Huat Goh; Lian-Kah Ti
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  16     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-02     Completed Date:  2002-11-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  456-8     Citation Subset:  IM    
Copyright Information:
Copyright 2002, Elsevier Science (USA). All rights reserved.
Affiliation:
Department of Anaesthesia and Surgical Intensive Care Unit, Singapore General Hospital, Singapore. markchow@bigfoot.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Body Height
Bronchi / surgery*
Equipment Design
Female
Follow-Up Studies
Humans
Intubation, Intratracheal / instrumentation*
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Statistics as Topic
Thoracic Surgical Procedures
Tomography, X-Ray Computed
Trachea / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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