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Double lumen tracheal 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
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
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
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)
K El-Boghdadly, C R Bailey, M D Wiles
Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre-existing lung disease, prolonged duration of anaesthesia and the presence of a blood-stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double-lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children...
June 2016: Anaesthesia
Yukihiro Imajo, Nobuyasu Komasawa, Yusuke Kusaka, Haruki Kido, Toshiaki Minami
Pulmonary arterial hypertension (PAH) is a known risk factor of perioperative complications, but the risks for non-cardiac operations have not yet been examined sufficiently. We report a case of a right lower lobectomy in a patient with PAH. A 73-year-old woman with Sjögren's syndrome was scheduled for right lowr lobectomy for primary lung cancer under general anesthesia. She was diagnosed with symptomatic PAH (estimated mean pulmonary arterial pressure, 40 mmHg) and medicated with ambrisentan. After induction of general anesthesia with propofol and fentanyl, a pulmonary artery catheter was placed to measure pulmonary artery pressure...
February 2016: Masui. the Japanese Journal of Anesthesiology
Takanobu Fujisawa, Nobuyasu Komasawa, Yu Miyazaki, Yusuke Kusaka, Fumihiro Ohchi, Toshiaki Minami
Anesthestic management with prolonged one-lung ventilation is difficult, especially when the patient continues smoking habit. Here, we report a successful one-lung ventilation and protection with combined use of double-lumen endotracheal tube and bronchial blocker. A 68-year-old man (height 153 cm; weight, 45 kg) was scheduled for simultaneous surgery of right lobectomy and esophagectomy. He kept smoking to the operation day. To protect the ventilated lung, we guided the bronchial lumen of the DLT to the left bronchus under fiberoptic bronchoscope (FOB) guide and inflated the bronchial cuff...
February 2016: Masui. the Japanese Journal of Anesthesiology
Haruki Kido, Nobuyasu Komasawa, Yukihiro Imajo, Takeshi Ueno, Toshiaki Minami
STUDY OBJECTIVE: Gentle and noninvasive double-lumen tracheal tube (DLT) extubation is important for both airway and circulatory management, especially after lung resection. We performed a prospective randomized clinical trial comparing DLT extubation force based on 2 different extraction angles. DESIGN: Randomized clinical trial. SETTING: Operating room. PATIENTS: Sixty adult patients scheduled for elective surgery under general anesthesia using DLT with ASA physical status 1 to 3...
March 2016: Journal of Clinical Anesthesia
J-H Seo, C W Cho, D M Hong, Y Jeon, J-H Bahk
BACKGROUND: It is well known that thermal softening of polyvinyl chloride tracheal tubes reduces nasal damage during nasotracheal intubation. We hypothesized that thermal softening of double-lumen endobronchial tubes (DLTs) may be effective for reducing airway injury. This randomized double-blind study was performed to investigate whether thermal softening of DLTs decreased postoperative sore throat, hoarseness or vocal cord injuries. METHODS: Patients (n=140) undergoing one lung anaesthesia were randomized into two groups (n=70 each) depending on whether the DLT was softened by warming or not before tracheal intubation...
February 2016: British Journal of Anaesthesia
Nao Tateura, Hiromi Sato, Takero Arai, Takashi Asai, Yasuhisa Okuda
A 54-year-old man with lung cancer was scheduled for thoracoscopic upper lobe resection under general anesthesia. About half a year previously, he had undergone surgery for oropharyngeal cancer and tongue cancer. As a result of the surgery, elasticity of the neck skin bending of the neck were restricted (Mallampati classification IV). A narrow-bored tracheostomy tube (speech cannula) was inserted. In the operating room, the tip of a 5.0 mm ID standard tube was inserted from the tracheostomy tube, and connected to a breathing circuit...
August 2015: Masui. the Japanese Journal of Anesthesiology
C A Wilson, O J Arthurs, A E Black, S Schievano, C Hunt, S van Hoog, C Wallis, M R J Sury
BACKGROUND: Single-lung ventilation in infants and small children is challenging because suitable sizes of double-lumen cuffed tracheal tubes are not available. A 6-yr-old child required pulmonary saline washout for primary alveolar proteinosis, and therefore needed sequential single-lung ventilation in order to achieve safe oxygenation. Before undertaking this potentially hazardous procedure, we practised bronchial intubation on an anatomical model of her airway constructed from computed tomography (CT) data...
October 2015: British Journal of Anaesthesia
Jee-Eun Chang, Seong-Won Min, Chong-Soo Kim, Sung-Hee Han, Yong-Suk Kwon, Jin-Young Hwang
PURPOSE: We evaluated the prophylactic effect of benzydamine hydrochloride (BH) spray on postoperative sore throat and hoarseness secondary to intubation with a double-lumen endobronchial tube (DLT). METHODS: Ninety-two adult patients undergoing thoracic surgery using DLT intubation were studied. The DLT cuff and oropharyngeal cavity were sprayed with normal saline (Group S; n = 46) or BH (Group BH; n = 46) prior to intubation. Postoperative sore throat and hoarseness were evaluated at one, six, and 24 hr after surgery...
October 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
João Batista Borges, Mert Senturk, Oskar Ahlgren, Göran Hedenstierna, Anders Larsson
OBJECTIVE: After lung recruitment, lateral decubitus and differential lung ventilation may enable the titration and application of optimum-selective positive end-expiratory pressure values for the dependent and nondependent lungs. We aimed at compare the effects of optimum-selective positive end-expiratory pressure with optimum global positive end-expiratory pressure on regional collapse and aeration distribution in an experimental model of acute respiratory distress syndrome. DESIGN: Prospective laboratory investigation...
October 2015: Critical Care Medicine
Enyu Liu, Abdul Qadir Khan, Jun Niu, Zongquan Xu, Cheng Peng
BACKGROUND: Natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) is an improvement in surgical interventions. In this study we developed an innovative transtracheal endoscopic thyroidectomy technique and explored its feasibility in animal models. MATERIALS AND METHODS: Transtracheal endoscopic thyroidectomy was performed in anesthetized dogs and pigs...
July 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Jun Liu, Fei Cui, Jianxing He
The lung isolation under general anaesthesia with double lumen tubes has become an indispensable part of video-assisted thoracoscopic surgery (VATS) for lung cancer. However, with an attempt to avoid the residual effects of muscle relaxants and the systemic complications due to tracheal intubation, anesthesia without tracheal intubation has also been applied in VATS surgeries for lung cancer. Currently, non-intubated anesthesia under spontaneous breathing has been widely applied in VATS, contributing to more stable anesthesia and lower rate of switching to intubated anesthesia...
May 2015: Annals of Translational Medicine
Thomas Hamp, Thomas Stumpner, Georg Grubhofer, Kurt Ruetzler, Rainer Thell, Helmut Hager
INTRODUCTION: Tracheal intubation causes a haemodynamic response that might be harmful for patients. The Airtraq® laryngoscope has been shown to decrease the haemodynamic response to single-lumen tube intubation. We hypothesised that double-lumen bronchial tube placement with the Double-lumen Airtraq® laryngoscope would cause a reduced haemodynamic response and decreased catecholamine release compared with the MacIntosh laryngoscope. METHODS: Forty adult patients were randomly assigned to the Airtraq® group or to the MacIntosh group...
2015: Heart, Lung and Vessels
W L Yao, L Wan, H Xu, W Qian, X R Wang, Y K Tian, C H Zhang
We compared the McGrath® Series 5 videolaryngoscope with the Macintosh laryngoscope for double-lumen tracheal tube placement in patients with a predicted good glottic view on assessment of the airway. An initial laryngoscopy was performed using the Macintosh laryngoscope; 96 patients with Cormack and Lehane grade-1 or -2a views were randomly assigned to undergo intubation using either the McGrath or Macintosh device. Compared with the Macintosh laryngoscope, the McGrath videolaryngoscope provided more Cormack and Lehane grade-1 views (47 (97...
July 2015: Anaesthesia
Michelle R Beam, Stephen O Bader
Failure of a double-lumen endotracheal tube (DLT) to isolate the lung during thoracic surgery can have significant consequences. In this report, we examine an approach for rescuing a malpositioned DLT. A 37F left-sided DLT was inserted and its proper position confirmed. After positioning, repeat confirmation of position and the ability to achieve 1-lung ventilation were performed, but inadequate isolation of the lung being operated on was noted after incision. A 7-Fr Arndt bronchial blocker was positioned through the tracheal lumen of the DLT to obtain 1-lung ventilation...
October 15, 2013: A & A Case Reports
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