Double-lumen endotracheal tube - Revision history

Jchen900 at 15:23, 20 August 2023

2023-08-20T15:23:23Z

← Older revision		Revision as of 08:23, 20 August 2023
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	== Indications<ref name=":0">{{Cite journal\|last=Hao\|first=David\|last2=Saddawi-Konefka\|first2=Daniel\|last3=Low\|first3=Sarah\|last4=Alfille\|first4=Paul\|last5=Baker\|first5=Keith\|date=2021-10-14\|editor-last=Ingelfinger\|editor-first=Julie R.\|title=Placement of a Double-Lumen Endotracheal Tube\|url=http://www.nejm.org/doi/10.1056/NEJMvcm2026684\|journal=New England Journal of Medicine\|language=en\|volume=385\|issue=16\|pages=e52\|doi=10.1056/NEJMvcm2026684\|issn=0028-4793}}</ref> ==		== Indications<ref name=":0">{{Cite journal\|last=Hao\|first=David\|last2=Saddawi-Konefka\|first2=Daniel\|last3=Low\|first3=Sarah\|last4=Alfille\|first4=Paul\|last5=Baker\|first5=Keith\|date=2021-10-14\|editor-last=Ingelfinger\|editor-first=Julie R.\|title=Placement of a Double-Lumen Endotracheal Tube\|url=http://www.nejm.org/doi/10.1056/NEJMvcm2026684\|journal=New England Journal of Medicine\|language=en\|volume=385\|issue=16\|pages=e52\|doi=10.1056/NEJMvcm2026684\|issn=0028-4793}}</ref> ==

	* Hemorrhage an infected abscess ~~into~~ a single lung requiring isolation		* Hemorrhage and infected abscess/spillage in a single lung requiring isolation
	* Controlled distributed ventilation for surgery		* Controlled distributed ventilation for surgery
	* Bronchopleural fistula, large lung bulla and or cysts		* Bronchopleural fistula, large lung bulla and or cysts
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	* Known difficult airway		* Known difficult airway
	* Tracheal stenosis		* Tracheal stenosis
	* ~~Severe~~ airway ~~distortion~~		* Airway distortion, lesions, masses that would preclude safe placement (e.g. tumors, airway strictures)
			*Presence of right upper bronchus takeoff above the carina (colloquially known as "pig bronchus") is an absolute contraindication for use of right sided DLTs

	== Setup ==		== Setup ==
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	* Fiberoptic bronchoscope for confirming post-placement position		* Fiberoptic bronchoscope for confirming post-placement position
	* Consider tooth guard to prevent shearing tracheal balloon during placement		* Consider tooth guard to prevent shearing tracheal balloon during placement
			*Water based lubricant applied to outside of ETT to facilitate placement (optional)

	=== Tube Selection Selection ===		=== Tube Selection Selection ===

Nkamdar: Intro paragraph.

2021-10-16T17:43:44Z

Intro paragraph.

← Older revision		Revision as of 10:43, 16 October 2021
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	}}		}}

	~~Provide~~ a ~~brief summary of this surgical procedure and its indications here~~.		A double-lumen endotracheal tube (DLT) is an airway device that is commonly used to facilitate one-lung ventilation strategy in [[thoracic surgery]], lung transplantation, or infection and trauma management of a single lung.

	== Indications<ref name=":0">{{Cite journal\|last=Hao\|first=David\|last2=Saddawi-Konefka\|first2=Daniel\|last3=Low\|first3=Sarah\|last4=Alfille\|first4=Paul\|last5=Baker\|first5=Keith\|date=2021-10-14\|editor-last=Ingelfinger\|editor-first=Julie R.\|title=Placement of a Double-Lumen Endotracheal Tube\|url=http://www.nejm.org/doi/10.1056/NEJMvcm2026684\|journal=New England Journal of Medicine\|language=en\|volume=385\|issue=16\|pages=e52\|doi=10.1056/NEJMvcm2026684\|issn=0028-4793}}</ref> ==		== Indications<ref name=":0">{{Cite journal\|last=Hao\|first=David\|last2=Saddawi-Konefka\|first2=Daniel\|last3=Low\|first3=Sarah\|last4=Alfille\|first4=Paul\|last5=Baker\|first5=Keith\|date=2021-10-14\|editor-last=Ingelfinger\|editor-first=Julie R.\|title=Placement of a Double-Lumen Endotracheal Tube\|url=http://www.nejm.org/doi/10.1056/NEJMvcm2026684\|journal=New England Journal of Medicine\|language=en\|volume=385\|issue=16\|pages=e52\|doi=10.1056/NEJMvcm2026684\|issn=0028-4793}}</ref> ==

Nkamdar at 17:39, 16 October 2021

2021-10-16T17:39:34Z

← Older revision		Revision as of 10:39, 16 October 2021
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	{{Infobox surgical case reference		{{Infobox surgical case reference
	\| anesthesia_type = Thoracic ~~anesthesia~~		\| anesthesia_type = Thoracic surgery
	\| airway =		\| airway =
	\| lines_access =		\| lines_access =

Nkamdar: Updated summary table

2021-10-16T17:36:20Z

Updated summary table

← Older revision		Revision as of 10:36, 16 October 2021
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	{{Infobox surgical case reference		{{Infobox surgical case reference
	\| anesthesia_type =		\| anesthesia_type = Thoracic anesthesia
	\| airway =		\| airway =
	\| lines_access =		\| lines_access =
	\| monitors =		\| monitors =
	\| considerations_preoperative =		\| considerations_preoperative =
	\| considerations_intraoperative =		\| considerations_intraoperative = Hypoxemia
	\| considerations_postoperative =		Misplacement
			Inadvertent airway suturing
			Airway perforation
			\| considerations_postoperative = Traumatic Laryngitis
			Vocal cord palsy
			Tracheal irritation
	}}		}}

	Provide a brief summary of this surgical procedure and its indications here.		Provide a brief summary of this surgical procedure and its indications here.

	== Indications ==		== Indications<ref name=":0">{{Cite journal\|last=Hao\|first=David\|last2=Saddawi-Konefka\|first2=Daniel\|last3=Low\|first3=Sarah\|last4=Alfille\|first4=Paul\|last5=Baker\|first5=Keith\|date=2021-10-14\|editor-last=Ingelfinger\|editor-first=Julie R.\|title=Placement of a Double-Lumen Endotracheal Tube\|url=http://www.nejm.org/doi/10.1056/NEJMvcm2026684\|journal=New England Journal of Medicine\|language=en\|volume=385\|issue=16\|pages=e52\|doi=10.1056/NEJMvcm2026684\|issn=0028-4793}}</ref> ==

	* Hemorrhage an infected abscess into a single lung requiring isolation		* Hemorrhage an infected abscess into a single lung requiring isolation
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	** Left pneumonectomy		** Left pneumonectomy
	** Left lung transplant		** Left lung transplant
			** Trauma to the left mainstem bronchus<ref name=":1">{{Cite journal\|last=Pedoto\|first=Alessia\|date=2012-12\|title=How to choose the double-lumen tube size and side: the eternal debate\|url=https://pubmed.ncbi.nlm.nih.gov/23089502\|journal=Anesthesiology Clinics\|volume=30\|issue=4\|pages=671–681\|doi=10.1016/j.anclin.2012.08.001\|issn=1932-2275\|pmid=23089502}}</ref>
	** Left tracheobronchial repair		** Left tracheobronchial repair
	** Consider for left thoracoscopic lung procedures (can be accomplished with L-DLT as well)		** Consider for left thoracoscopic lung procedures (can be accomplished with L-DLT as well)

	==== Tube Size Selection ====		==== Tube Size Selection ====
			Several sources of literature help anesthesiologists choose the correct size DLT:

			# Pedoto (2012)<ref name=":1" />
			# Brodsky et al. (1999)<ref>{{Cite journal\|last=Brodsky\|first=J. B.\|last2=Fitzmaurice\|first2=B. G.\|last3=Macario\|first3=A.\|date=1999-02\|title=Selecting double-lumen tubes for small patients\|url=https://pubmed.ncbi.nlm.nih.gov/9972778\|journal=Anesthesia and Analgesia\|volume=88\|issue=2\|pages=466–467\|doi=10.1097/00000539-199902000-00049\|issn=0003-2999\|pmid=9972778}}</ref>
			# Hao etl al. (2021)<ref name=":0" />

			== Complications ==

			* Laryngitis
			* Tracheal irritation
			* Vocal cord palsy
			* Airway rupture or perforation (<1% total incidence<ref>{{Cite journal\|last=Fitzmaurice\|first=B. G.\|last2=Brodsky\|first2=J. B.\|date=1999-06\|title=Airway rupture from double-lumen tubes\|url=https://pubmed.ncbi.nlm.nih.gov/10392687\|journal=Journal of Cardiothoracic and Vascular Anesthesia\|volume=13\|issue=3\|pages=322–329\|doi=10.1016/s1053-0770(99)90273-2\|issn=1053-0770\|pmid=10392687}}</ref>): trachea (52.4%) and left main bronchus (37.4%) are the most common sites<ref>{{Cite journal\|last=Liu\|first=Shiqing\|last2=Mao\|first2=Yuqiang\|last3=Qiu\|first3=Peng\|last4=Faridovich\|first4=Khasanov Anvar\|last5=Dong\|first5=Youjing\|date=2020-11\|title=Airway Rupture Caused by Double-Lumen Tubes: A Review of 187 Cases\|url=https://pubmed.ncbi.nlm.nih.gov/33079871\|journal=Anesthesia and Analgesia\|volume=131\|issue=5\|pages=1485–1490\|doi=10.1213/ANE.0000000000004669\|issn=1526-7598\|pmid=33079871}}</ref>

	== Technical Specifications ==		== Technical Specifications ==


	== References ==		== References ==

	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]

Nkamdar at 17:10, 16 October 2021

2021-10-16T17:10:49Z

← Older revision		Revision as of 10:10, 16 October 2021
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	* Tracheal stenosis		* Tracheal stenosis
	* Severe airway distortion		* Severe airway distortion

	~~=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===~~

	~~=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===~~

	~~=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===~~

	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

	== Setup ==		== Setup ==

Nkamdar at 17:09, 16 October 2021

2021-10-16T17:09:06Z

← Older revision		Revision as of 10:09, 16 October 2021
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	* Tracheobronchial disruption		* Tracheobronchial disruption
	* Single-lung lavage for pulmonary alveolar proteinosis		* Single-lung lavage for pulmonary alveolar proteinosis

	~~=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===~~

	== Contraindications ==		== Contraindications ==
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	* Fiberoptic bronchoscope for confirming post-placement position		* Fiberoptic bronchoscope for confirming post-placement position
	* Consider tooth guard to prevent shearing tracheal balloon during placement		* Consider tooth guard to prevent shearing tracheal balloon during placement

			=== Tube Selection Selection ===

			* Most single-lung ventilation procedures can be accomplished with a left-sided DLT
			* Right DLT indications
			** Left pneumonectomy
			** Left lung transplant
			** Left tracheobronchial repair
			** Consider for left thoracoscopic lung procedures (can be accomplished with L-DLT as well)

			==== Tube Size Selection ====

	== Technical Specifications ==		== Technical Specifications ==

Nkamdar: Edited sub-headings for appropriate topics with placement of specialized anesthesia equipment.

2021-10-16T16:55:18Z

Edited sub-headings for appropriate topics with placement of specialized anesthesia equipment.

← Older revision		Revision as of 09:55, 16 October 2021
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	Provide a brief summary of this surgical procedure and its indications here.		Provide a brief summary of this surgical procedure and its indications here.

	== ~~Preoperative management~~ ==		== Indications ==

	~~=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none~~, ~~this section may be removed. -~~-~~> ===~~		* Hemorrhage an infected abscess into a single lung requiring isolation
			* Controlled distributed ventilation for surgery
			* Bronchopleural fistula, large lung bulla and or cysts
			* Tracheobronchial disruption
			* Single-lung lavage for pulmonary alveolar proteinosis

	=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===		=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===

	== ~~Intraoperative management~~ ==		== Contraindications ==

			* Known difficult airway
			* Tracheal stenosis
			* Severe airway distortion

	=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===		=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===
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	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

			== Setup ==

			=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===

			* DLT with appropriately chosen size
			* Laryngoscope (video or direct laryngoscope)
			* Syringes 3mL (bronchial cuff) and 10mL (tracheal cuff)
			* Fiberoptic bronchoscope for confirming post-placement position
			* Consider tooth guard to prevent shearing tracheal balloon during placement

			== Technical Specifications ==

	== References ==		== References ==

	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]

Chetra.Yean: Created page with "{{Infobox surgical case reference | anesthesia_type = | airway = | lines_access = | monitors = | considerations_preoperative = | considerations_intraoperative = | consid..."

2021-04-19T21:24:10Z

Created page with "{{Infobox surgical case reference | anesthesia_type = | airway = | lines_access = | monitors = | considerations_preoperative = | considerations_intraoperative = | consid..."

New page

{{Infobox surgical case reference
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Preoperative management ==

=== Operating room setup ===

=== Patient preparation and premedication ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

=== Maintenance and surgical considerations ===

== References ==

[[Category:Surgical procedures]]