Does the presence of a tracheal bronchus affect the margin of safety of double-lumen tube placement?
During double-lumen tube (DLT) placement, the anesthesiologist must be mindful of the margin of safety. We determined how this margin is affected by the presence of a tracheal bronchus by elucidating the mathematical relationship between some relevant physical dimensions of the trachea, bronchi, and DLT. Our results suggest that a tracheal bronchus only rarely affects the intrinsic margin of safety of DLT placement. When the tracheal bronchus is located much higher than its most frequently seen location (within 2 cm from the carina), however, there is increased risk that it could be blocked by the tracheal cuff of a left-sided DLT.
*Department of Anaesthesia & Intensive Care, †Diagnostic Radiology and Organ Imaging, †Department of Surgery, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, PRC, and §Brock University, St. Catharines, Ontario, Canada.
Anthony M-H
AM
Ho
Manoj K
MK
Karmakar
Wynnie W M
WWM
Lam
Freda O
FO
Lam
T W
TW
Lee
S K
SK
Ng
David C
DC
Chung
D001980:Bronchi / Q000002:abnormalities*; D001999:Bronchoscopy; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation; D014132:Trachea / Q000002:abnormalities*