Double-lumen endotracheal tube

Double-lumen endotracheal tube

Anesthesia type
Airway
Lines and access
Monitors
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative
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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)