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double lumen tube

Shiho Deguchi, Nobuyasu Komasawa, Haruki Kido, Takeshi Ueno, Toshiaki Minami
STUDY OBJECTIVE: This study aimed to compare the impact of pillow height on double-lumen tracheal tube (DLT) intubation with McGRATH MAC (McG) in patients undergoing elective surgery. DESIGN: Randomized clinical trial. SETTING: Operating room. PATIENTS: Fifty adult patients scheduled for elective surgery under 1-lung ventilation with an American Society of Anesthesiologists physical status of 1 to 3. INTERVENTIONS: DLT intubation with McG was performed with a high pillow (HP group; 25 patients) or low pillow (LP group; 25 patients) by anesthesiologists...
November 2016: Journal of Clinical Anesthesia
Elisa D'Alessandro, Jacopo M Guidotti, Kaweh Mansouri, André Mermoud
BACKGROUND: Glaucoma drainage devices have traditionally been reserved for patients with refractory glaucoma. However, these devices are prone to various sight-threatening complications. To prevent hypotony after placement of the Baerveldt tube, surgeons traditionally tie the tube with an absorbable suture until encapsulation occurs around the plate. We hypothesized that combining the XEN tube, placing it in the anterior chamber and connecting it to the Baerveldt tube posteriorly, outside the anterior chamber, would minimize 2 main potentially blinding complications: hypotony and corneal disease...
September 21, 2016: Journal of Glaucoma
Vandana Pandey, Dharam S Meena, Swati Choraria, Sushil Guria
Tracheobronchial injuries are rare cases requiring skillful airway management. We report a challenging case of tracheobronchial injury in a young adult who was run over by a tractor and was referred to us from a peripheral hospital with endotracheal tube in situ. He was severely hypoxaemic on initial presentation. Diagnostic work up showed high suspicion for right bronchial transection along with left lung upper lobe contusion. Due to deteriorating clinical condition of the patient and despite immediate unavailability of fibreoptic bronchoscope, patient was immediately taken up for right posterolateral thoracotomy and double lumen tube was inserted...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Michael Gottlieb, Vibhu Sharma, John Field, Michael Rozum, John Bailitz
INTRODUCTION: Patients with severe pulmonary hemorrhage due to unilateral trauma or a bleeding cancer often present to the emergency department in acute respiratory distress. Although it is generally recommended to perform single lung intubation, most emergency department providers do not have access to or are not familiar with double-lumen endotracheal tubes, and blind insertion of an endotracheal tube to maximum depth does not ensure that the proper (nonhemorrhagic) lung is ventilated...
August 27, 2016: American Journal of Emergency Medicine
Rajesh V Patel, Brandon A Van Noord, Dakshesh Patel, Elizabeth J Hong, Eric Bourne, Reema R Patel, Janak Chandrasoma, Linda Chan, Janos Szenohradszki, Philip D Lumb
OBJECTIVES: This study aimed to determine the true inclination angle of the main bronchi relative to the median sagittal plane, using CT imaging to help increase accuracy of double-lumen tube (DLT) placement. DESIGN: In this retrospective study, 2 investigators independently measured normal chest CT scans from 50 male and 50 female patients. To determine the true AP axis, a mid-sagittal plane reference line (MSPRL) was drawn, intersecting the midsternum and the vertebral spinous process at the level of mid-carina...
June 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Ilaria Campo, Maurizio Luisetti, Matthias Griese, Bruce C Trapnell, Francesco Bonella, Jan Grutters, Koh Nakata, Coline H M Van Moorsel, Ulrich Costabel, Vincent Cottin, Toshio Ichiwata, Yoshikazu Inoue, Antonio Braschi, Giacomo Bonizzoni, Giorgio A Iotti, Carmine Tinelli, Giuseppe Rodi
BACKGROUND: Whole lung lavage (WLL) is the current standard of care treatment for patients affected by pulmonary alveolar proteinosis (PAP). However, WLL is not standardized and international consensus documents are lacking. Our aim was to obtain a factual portrayal of WLL as currently practiced with respect to the procedure, indications for its use, evaluation of therapeutic benefit and complication rate. METHODS: A clinical practice survey was conducted globally by means of a questionnaire and included 27 centers performing WLL in pediatric and/or adult PAP patients...
2016: Orphanet Journal of Rare Diseases
Manila Singh, Rajeev Uppal, Kapil Chaudhary, Amit Javed, Anil Aggarwal
Minimally invasive and hybrid minimally invasive esophagectomy (MIE) is a technically challenging procedure. Anesthesia for the same is equally challenging due to special requirements of the video-assisted thoracoscopic technique used and shared operative and respiratory fields. Standard ventilatory strategy for this kind of surgery has been 1-lung ventilation with the help of a double-lumen tube. Prone positioning for thoracoscopic dissection facilitates gravity-dependant collapse of the operative side lung induced by a unilateral capnothorax, thus making the use of single-lumen endotracheal tube a feasible option for this surgery...
September 2016: Journal of Clinical Anesthesia
Ayten Saracoglu, Kemal T Saracoglu
STUDY OBJECTIVE: To evaluate the available data describing the use of single and double lumen VivaSight tubes. DESIGN: Systematic review. SETTING: The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and possible complications. PATIENTS: Systematic review of randomized controlled trials from databases including Medline, Web of Knowledge, Google Scholar, and Cochrane Central Register of Controlled Trials...
September 2016: Journal of Clinical Anesthesia
V Mixa, B Nedomova, M Rygl
Selective lung intubation is a necessary prerequisite for the completion of most interventions comprising thoracotomy and thoracoscopy. In paediatric care, our site uses Univent tubes for children up to the age of three years and double-lumen tubes (DLT) for children from 6-8 years of age. In younger children, we usually use regular endotracheal intubation, with the lung being held in the hemithorax position being operated on using a surgical retractor. The article presents the analysis of 860 thoracic surgeries, of which 491 comprised selective intubation (Univent 57 cases, DLT 434 cases)...
2016: Bratislavské Lekárske Listy
Jeong Jin Min, Jong-Hwan Lee, Se Hee Kang, Eunhee Kim, Sangmin M Lee, Jong Ho Cho, Hong Kwan Kim
UNLABELLED: To find the faster and easier way than the existing intubating technique for double-lumen tube, we modified the angle of double-lumen tube according to an individual's upper airway anatomy and compared the time needed and the number of attempts for successful intubation between individually angle-modified and non-modified double-lumen tubes. Adult patients undergoing elective thoracic surgery were randomly allocated in either non-angle-modified (Group N, n = 54) or angle-modified (Group M, n = 54) groups...
2016: PloS One
Adi Osman, Kok Meng Sum
Upper airway ultrasound is a valuable, non-invasive, simple, and portable point of care ultrasound (POCUS) for evaluation of airway management even in anatomy distorted by pathology or trauma. Ultrasound enables us to identify important sonoanatomy of the upper airway such as thyroid cartilage, epiglottis, cricoid cartilage, cricothyroid membrane, tracheal cartilages, and esophagus. Understanding this applied sonoanatomy facilitates clinician to use ultrasound in assessment of airway anatomy for difficult intubation, ETT and LMA placement and depth, assessment of airway size, ultrasound-guided invasive procedures such as percutaneous needle cricothyroidotomy and tracheostomy, prediction of postextubation stridor and left double-lumen bronchial tube size, and detecting upper airway pathologies...
2016: Journal of Intensive Care
Johannes Spaeth, Andrea Hojnik, Matthias Ott, Steffen Wirth, Matthias Schneider, Torsten Loop, Stefan Schumann
OBJECTIVES: To determine pressure-flow characteristics of double-lumen tubes (DLTs) with an outer diameter of 26 to 41 French and calculate bronchial pressure in a model setup and using data from patients who underwent one-lung ventilation with a DLT. DESIGN: Prospective experimental study and retrospective analysis of clinical measurements. SETTING: University medical center. PARTICIPANTS: Lung model and patients. INTERVENTIONS: Flow rates and pressure gradients across Robertshaw-type DLTs (∆P(DLT)) were measured in a physical model and the DLT-specific resistance coefficients were calculated from ∆P(DLT) according to Rohrer's approach...
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
Mika Sato, Miyuki Takesue, Kenji Kayashima
We encountered difficulty in inserting a 32-Fr left double-lumen tube (DLT) in a small 75-year-old Japanese woman (height, 144 cm). The 32-Fr DLT with 10.1 × 11.2-mm tracheal diameter could not pass through the cricoid cartilage with a 9.2-mm transverse inner width. The transverse inner width of the cricoid cartilage, in addition to the tracheal and bronchial diameter, can be measured using computed tomography or ultrasonography in small women. Thus, a 28-Fr DLT or single-lumen tube and a blocker can be selected instead of a 32-Fr DLT when the width of the cricoid cartilage is <10 mm...
October 1, 2016: A & A Case Reports
Marco Chiarelli, Martino Gerosa, Angelo Guttadauro, Francesco Gabrielli, Giuseppe Vertemati, Massimo Cazzaniga, Luca Fumagalli, Matilde De Simone, Ugo Cioffi
BACKGROUND: The majority of patients with severe blunt chest trauma is successfully treated with supportive measures and thoracostomy tube; only few cases need urgent thoracotomy. Lung-sparing techniques are treatments of choice but major pulmonary resections are necessary in case of injuries involving hilar vessels or bronchi. Currently the mortality associated with pulmonary lobectomy performed for chest trauma is 40%. METHODS: Over a 2-year period [2013-2014], 210 patients with chest trauma were hospitalized at our Institution...
July 2016: Journal of Thoracic Disease
Sung Hye Byun, Su Hwang Kang, Jong Hae Kim, Taeha Ryu, Baek Jin Kim, Jin Yong Jung
BACKGROUND: Double-lumen endotracheal tubes (DLTs) are often displaced during change from the supine to the lateral decubitus position. The aim of this study was to determine whether Rescuefix, a recently developed tube-holder device, is more effective than the traditional tape-tying method for tube security during lateral positioning. METHODS: Patients were randomly assigned to a Rescuefix (R) group (n = 22) or a tape (T) group (n = 22). After intubation with a left-sided DLT and adjustment of the appropriate DLT position using a fiberoptic bronchoscope, the DLT was fixed firmly at the side of the mouth by either Rescuefix or Durapore tape...
August 2016: Medicine (Baltimore)
Yen-I Chen, Mouen A Khashab
PURPOSE OF REVIEW: Malignant gastric outlet obstruction (GOO) is a debilitating complication of cancer associated with a poor prognosis. The primary aim in the management of malignant GOO is usually palliation starting with the reinstitution of luminal patency with either surgical bypass or enteral stenting. These traditional modalities, however, have important limitations. Endoscopic bypass is a novel approach to GOO and may be an ideal technique, in which a sustained bypass can be created through a minimally invasive approach...
July 6, 2016: Current Opinion in Gastroenterology
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Leszek Hurkała, Emil Płowiecki
This paper presents the results of endoscopic treatment for recurrent post-corrosive oesophageal stenosis with a tube-stent developed at our institution.The tube-stent was implanted in five children with corrosive oesophageal injury at the age of 2-8.5 years after 7-64 dilatation sessions over 5-118 months. In total, 13 tube-stent were implanted. One patient had nine procedures over 2.5 years and the tube-stent remained in place for 14-250 days. This patient was tube-stent-dependent due to the lack of any possibility of surgical reconstruction...
July 2, 2016: Journal of Pediatric Gastroenterology and Nutrition
C Srinivasan, G P Kurian, R Mariappan
The main goals of neuroanesthesia are the maintenance of adequate cerebral perfusion pressure, avoidance of hypercarbia, hypoxemia, and to provide better brain relaxation. Providing anesthesia for a patient with bronchiectasis needing lung isolation for craniotomy can be challenging. A 56-year-old male patient, case of right lung bronchiectasis with a right cerebello pontine angle tumor underwent excision in the left lateral position. Since he had severe bronchiectasis of the right lung, we had isolated the right lung using right-sided double lumen tube to avoid spillage...
July 2016: Saudi Journal of Anaesthesia
Song Zhao, Weidong Tong
Anastomotic leakage (AL) is one of the most serious complications of anterior resection for rectal cancer with morbidity about 10%. Distance of anastomosis to anal margin, underlying disease, surgical technique and perioperative situations are associated with AL. The transanal drainage tube (TDT) after anastomosis is gradually proved to be useful in prevention of AL. Most of the literatures suggest that TDT is simple and safe, and can reduce the incidence of AL. The materials and the operating process of TDT have been universalized gradually: application of silicone or rubber material, large lumen with several side holes, placement at a distance of 3 to 5 cm above the anastomosis for 5 to 7 days...
June 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Sook Young Lee, Ji Young Yoo, Jong Yeop Kim, Dae Hee Kim, Jung Dong Lee, Go Un Rho, Hyungbae Park, Sung Yong Park
Opioids are used as a treatment for coughing. Recent studies have reported an antitussive effect of remifentanil during recovery from general anesthesia by suppressed coughing. The coughing reflex may differ throughout the respiratory tract from the larynx to the bronchi. But the proper dose of remifentanil to prevent cough during double-lumen tube (DLT) extubation is unknown.Twenty-five ASA physical status 1 and 2 patients, 20 to 65 years of age who were undergoing video-assisted thoracoscopic lung surgery requiring 1-lung ventilation were enrolled...
June 2016: Medicine (Baltimore)
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