Estimation of the depth of left-sided double-lumen endobronchial tube placement using preoperative chest radiographs.
BACKGROUND
Accurate placement of the double-lumen endobronchial tube (DLETs) is essential for optimal gas exchange during one-lung ventilation. The present study was designed to estimate the insertion depth of left-sided DLET using a preoperative chest radiograph.


METHODS
Forty-five patients who underwent thoracic operations requiring intubation of a DLET were studied. The distance between the cephalic edge of the sixth cervical vertebra and the carina of the trachea (Dc-c) was measured from the anterior-posterior view of preoperative chest radiograph. After the tube was positioned in the main bronchus, a fiberoptic bronchoscope was introduced into the tracheal lumen to ensure the appropriate position of the DLET. Simple regression analysis for the insertion depth of the DLETs and Dc-c was performed.


RESULTS
There was a highly significant correlation between the insertion depth of the DLET and both the Dc-c (y = 0.5304x + 19.646) and the body height (y = 0.1022x + 10.525), with P < 0.001 and P < 0.01, respectively.


CONCLUSIONS
To get the distance from the cephalic edge of the 6th cervical vertebra to the Dc-c from the chest radiograph preoperatively would be helpful for the evaluation of the proper insertion depth of the placement of DLET.
Chang
Pei-Jung
PJ
Department of Anesthesiology, National Cheng Kung University Medical Center, Tainan, Taiwan, R.O.C.
Sung
Yen-Hei
YH
Wang
Li-Kai
LK
Tsai
Yu-Chuan
YC
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D013902:Radiography, Thoracic