Predicting Optimal Insertion Depth of a Left-sided Double-Lumen Endobronchial Tube

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• 作者：Wei-Lin Lin ; MD ; Chen-Hwan Cherng ; MD ; PhD ; ^{cherng1018@yahoo.com.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：double-lumen endobronchial tube ; insertion depth ; one lung ventilation ; thoracic anaesthesia
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：30
• 期：4
• 页码：942-946
• 全文大小：352 K

文摘

Appropriate placement of the double-lumen endobronchial tube (DLT) is essential for one-lung ventilation. Several formulae based on body height (BH) have been used for estimating the optimal insertion depth of a left-sided DLT. In this study, the authors examined the following 5 formulae for accuracy of prediction: 0.11×BH+10.53 (cm) from Brodsky et al¹; 0.15×BH+3.96 (cm) from Bahk and Oh²; 0.148×BH+3.8 (cm) from Chow et al;³ 0.1×BH+12.5 (cm) from Takita et al⁴; and 0.1977×BH – 4.2423 (cm) (authors’ formula).

Design

Single-center, retrospective, observational study.

Setting

University hospital.

Participants

Anesthetic records of patients older than 20 years who received one-lung ventilation using a left-sided DLT were included.

Interventions

The patients’ sex, age, body weight, BH, and the final correct insertion depth of the left-sided DLT after fiberscope verification were recorded. Linear regression and correlation were used to analyze the data.

Measurements and Main Results

One hundred seventy anesthetic records were analyzed. The insertion depth was distributed normally in 4 groups with different BH intervals. The correlations between the correct insertion depth and all the lengths calculated using each formula were significant (p<0.001), with a similar high coefficient of determination (r = 0.809). The regression line derived from the authors’ formula—0.1977×BH – 4.2423 (cm)—showed the most accuracy in predicting the correct insertion depth.

Conclusions

The height-based formula of 170 – 29.5 – 5 – 1 (the insertion depth is 29.5 cm for patients who are 170 cm tall, and the insertion length is increased or decreased by 1 cm for every 5 cm increase or decrease in BH) modified by the equation of 0.1977×BH – 4.2423 is a useful tool to predict the optimal insertion depth in initially blind left-sided DLT insertion.