This study measures the resistance to gas flow of different double-lumen bronchial tubes used for separate ventilation of each lung in critically ill patients. Different-sized Robertshaw and Carlens' tubes were studied, as well as a new device that consisted of a cuffed bronchial catheter introduced through a standard tracheal tube. The pressure-flow relationship was curvilinear in all cases. Robertshaw and Carlens' tubes were generally found to have bronchial and tracheal channels with almost similar resistance and offered total resistances similar to those of 7.0-8.0 mm internal diameter tracheal tubes. The new device had a higher resistance than others of equal external diameter. This must be taken into account when its use is recommended for prolonged respiratory support.
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http://dx.doi.org/10.1111/j.1365-2044.1989.tb11291.x | DOI Listing |
Ann Thorac Surg Short Rep
December 2024
Division of Thoracic and Cardiovascular Surgery, Lahey Hospital, Burlington, Massachusetts.
The double-lumen endotracheal tube (DLT) was introduced by Carlens in 1949 and became widely used for single-lung ventilation. DLTs have since become standard for most pulmonary resections. Although the use of DLTs is routine and safe in experienced hands, it is not without risk.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
March 2024
Cardiothoracic Anesthesia, Anesthesiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; Cardiothoracic Anaesthesia Unit, Department of Anaesthesia, Surgical Intensive Care and Pain Medicine, College of Medicine, Mansoura University, Mansour, Egypt. Electronic address:
Innovations and challenges for lung separation or isolation have evolved during the last few years. In this chapter, we present the up-to-date, robust evidence available during the previous five years supporting the positions of the different devices, techniques, and tricks for their use in adult and pediatric patients undergoing various thoracic surgical interventions. Additionally, we presented an update on lung isolation in patients with airway difficulty and the suggested training level to master these techniques.
View Article and Find Full Text PDFJA Clin Rep
November 2024
Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan.
Background: Anesthetic management of a patient with multiple giant bullae is generally difficult due to an increased risk of respiratory complications, and there is no consensus regarding safe extubation methods. We report a case of an effective use of a supraglottic airway (i-gel™) during emergence from anesthesia in a patient with multiple giant bullae, in whom a double-lumen bronchial tube was being used during anesthesia.
Case Presentation: A 52-year-old man with multiple giant bullae underwent video-assisted pulmonary resections, while the ventilation was controlled via a double-lumen bronchial tube.
Thorac Cardiovasc Surg
November 2024
Department of Anesthesiology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Bayern, Germany.
Background: Difficult airway management is essential in anesthesia practice. Particular challenges are posed to patients who require intraoperative one-lung ventilation. Specific guidelines for these scenarios have been lacking.
View Article and Find Full Text PDFBMC Pulm Med
November 2024
Department of Anesthesiology, Lu'an Hospital of Anhui Medical University, Lu'an, 237000, China.
Objective: To study the clinical effectiveness of visual laryngoscopy combined with fiberoptic bronchoscopy-guided double-lumen endotracheal tube intubation in thoracic surgery patients with predicted difficult airways in thoracic surgery airways.
Methods: We randomly divided 162 patients with predicted difficult airways who required double-lumen tracheal intubation for thoracic surgery and randomly divided them into the video laryngoscopy group (Group VL, n = 54),fiberoptic bronchoscopy group (Group F, n = 54), and video laryngoscopy combined with fiberoptic bronchoscopy group (Group FVL, n = 54) according to the randomized number table method. Then, the success rate of the first intubation, the duration of intubation, the duration of positioning, the degree of exposure of the vocal cords (Cormack-Lehane grade), and the adverse reactions during intubation were recorded and analyzed.
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