Document Detail

The single-connector technique for initial placement of double-lumen tubes.
MedLine Citation:
PMID:  15535496     Owner:  NLM     Status:  MEDLINE    
Due to the presence of major lung or extra-pulmonary pathology, which may be unilateral or bilateral, the initial placement of a double-lumen tube is not always straightforward. Although fibreoptic bronchoscopy is often used to confirm "correct" placement, a "blind" technique is frequently used for the initial insertion. The currently widely taught blind technique involves tracheal cuff inflation and ventilation of both lungs as a first manoeuvre, with a subsequent assessment of single-lung ventilation by clamping off in turn, the two limbs of the double-lumen tube double-connector: An alternative approach involves the bronchial cuff being inflated first, and then using a single-connector to transfer ventilation from one lung to the other. In this paper this technique is described and compared to the more traditional method. On a purely "number of steps" basis, the single-connector approach has several advantages. Furthermore, use of a technique that involves bronchial cuff inflation and single-lung ventilation as a first manoeuvre may reduce the risk of a temporarily malplaced double-lumen tube creating a potentially harmful ball-valve effect in a partially obstructed lobe or lung.
J Pfitzner; H I Alexander; P K Hung
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  32     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-11-10     Completed Date:  2005-01-27     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  685-92     Citation Subset:  IM    
Department of Anaesthesia, The Queen Elizabeth Hospital, Woodville, South Australia.
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MeSH Terms
Anesthesia, Inhalation / instrumentation*,  methods
Bronchi / anatomy & histology
Equipment Design
Equipment Safety
Fiber Optic Technology
Intubation, Intratracheal / instrumentation*,  methods
Risk Assessment
Sensitivity and Specificity

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