Difference between revisions of "Double-lumen endotracheal tube"

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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 ==

Revision as of 09:10, 16 October 2021

Double-lumen endotracheal tube
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Lines and access
Monitors
Primary anesthetic considerations
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Provide a brief summary of this surgical procedure and its indications here.

Indications

  • 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

Contraindications

  • Known difficult airway
  • Tracheal stenosis
  • Severe airway distortion

Setup

Operating room setup

  • 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

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

References

Top contributors: Nirav Kamdar, Chetra Yean and Gang Chen

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