| Margin of Safety in Positioning Double-lumen Endotracheal Tubes Using a Fiberoptic Bronchoscope in Korean Adult. |
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Jung Won Park, Eun Gil Rah, Bo Ryoung Lee, Chong Wha Baek, Young Hun Jung, Soo Won Oh, Young Cheol Woo, Jin Yun Kim, Gill Hoi Koo, Sun Gyoo Park |
1Department of Anesthesiology, College of Medicine, Chungang University, Seoul, Korea. pjw2002@cau.ac.kr
2Department of Anesthesiology, No-Won Eul-Ji Hospital, Seoul, Korea. |
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| Abstract |
BACKGROUND
The margin of safety is the length of the mainstem bronchi, over which double-lumen endotracheal tubes (DLTs) can be moved and still be correctly positioned. A negative value of margin of safety means that DLTs may not be safe. We measured the length of the left and right mainstem bronchi and margin of safety in Korean adults.
METHODS
One hundred and fifty-six ASA I or II adult patients undergoing an elective surgery were examined. After nduction of general anesthesia, we measured the lengths from the upper incisor to the tracheal carina, to the proximal margin of the left and right upper lobe bronchial opening using a fiberoptic bronchoscope. We calculated the lengths of the left and right mainstem bronchi and margin of safety using the measured lengths.
RESULTS
In Korean adults, the average margin of safety of left-sided DLTs of males and females was 2.4 +/- 1.0 cm and 1.9 0.7 cm and right-sided DLTs of males and females was 1.0 +/- 0.9 cm and 0.8 +/- 0.3 cm, respectively. The percentage of a negative value of the margin of safety in positioning right-sided DLTs was 10.4% in males and 8.6% in females. However, all values of the margin of safety in left-sided DLTs were positive.
CONCLUSIONS
Using left-sided DLTs, regardless of the operative side, is better than right-sided DLTs because left-sided DLTs have a greater margin of safety in positioning. If we use right-sided DLTs, we should confirm the proper position of tubes using a fiberoptic bronchoscope. |
| Key Words:
Bronchus; fiberoptic bronchoscopy; margin of safety; one-lung ventilation |
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