Insertion Depth of Left-sided Double-lumen Tube: a New Predictive Formula

Summary

The authors developed a formula for predicting the accurate depth of DLT insertion into the appropriate bronchus based on height as follows \[The predicted insertion depth of left DLT (cm) equals 0.249 × (BH)0.916\] \[R\]. That pilot study showed comparable correlations between five formulae \[Brodsky et al, Bahk and Oh R, Takita et al, Chow et al, Lin\]. However, that formula developed has not been validated yet.

We hypothesized that previously published formula would predict the accurate depth of left-sided DLT insertion. We aimed to investigate the efficacy of this formula to estimate the optimum insertion depth of the DLT using a flexible bronchoscope and decrease the incidence of DLT displacement into the appropriate bronchus, the need for bronchoscopic adjustment, and complications including soreness of throat and mucosal injury.

Conditions

• Thoracic Surgery
• One Lung Ventilation
• Left-sided Double Lumen Tube

Interventions

OTHER

Predicted depth of insertion

A left-sided double-lumen tube was introduced beyond the vocal cords when the train-of-four stimulation of the ulnar nerve revealed 1 or 2 twitches, the stylet was removed, the double-lumen tube was rotated 90° counterclockwise and then advanced blindly to the predicted depth of insertion.

OTHER

Optimized depth of insertion

The optimal position of the double-lumen tube, defined as the inflated endobronchial cuff is placed in the left main bronchus just below the carina without herniation, which was confirmed using a flexible bronchoscope in both supine and lateral decubitus positions.

OTHER

Adjustment of depth of insertion

If the endobronchial cuff was placed too deeply or too proximal, subsequently, the double-lumen tube was withdrawn or advanced, respectively, using the flexible bronchoscope until the optimum position of the double-lumen tube was achieved.

Sponsors & Collaborators

• King Saud University

  collaborator OTHER

• Imam Abdulrahman Bin Faisal University

  lead OTHER

Principal Investigators

• Abdelazeem A Eldawlatly, MD · Professor of Anesthesia, College of Medicine, King Saud University

• Mohamed R El Tahan, MD · Associate Professor of Cardiothoracic Anaesthesia & Surgical Intensive Care, Imam Abdulrahman Bin Faisal University (formerly, University of Dammam), Dammam, Saudi Arabia,

Study Design

Allocation

NA

Purpose

OTHER

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-05-07

Primary Completion

2020-03-01

Completion

2020-03-15

Countries

• Saudi Arabia

Study Locations