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Bronchial cuff pressure change caused by left-sided double-lumen endobronchial tube displacement

Kazukuni Araki, MD^*, Ryoichi Nomura, MD^*, Reiko Urushibara, MD^*, Yukiko Yoshikawa, MD^* and Yoshio Hatano, MD

^* From the Departments of Anesthesiology, Ohtsu Red Cross Hospital, 1-1-35 Nagara, Ohtsu, Shiga 520-8511, Japan; and
Wakayama Medical College, Wakayama, Japan.

Address correspondence to: Address correspondence to: K. Araki MD. Phone: 81-77-522-4131; Fax: 81-77-525-8018.

Purpose: The bronchial cuff pressures (BCPs) of left-sided double-lumen endobronchial tubes (DLTs) manufactured by Rüsch and Mallinckrodt were measured in 80 patients when the tubes were withdrawn to compare the effect of tube design on BCP change.

Methods: During general anesthesia with muscle relaxation, the cephalad surface of the endobronchial cuff was positioned either 2.5 cm distal to the carina (Rüsch Group R-I; n = 20 and Mallinckrodt Group B-I; n = 20) or just below the carina (Rüsch Group R- II; n = 20 and Mallinckrodt Group B- II; n = 20) and the cuff was inflated to 35 cm H₂O. The tube was then withdrawn in 0.5-cm steps until the cuff was 2.0 cm proximal to the carina, the position just before the capnogram or pressure-volume loop of tracheal lumen changed. The BCP at each step was measured. The rate of decrease in BCP was defined as the decrease of BCP divided by the length of displacement of DLT.

Results: The rates of decrease from the +2.5 cm position to the end point in Group B-I (7.7 ± 0.8 cm H₂O•cm^-1) and those from the most proximal acceptable position to the end point in Group B-II (19.5 ± 4.8 cm H₂O•cm^-1) were greater than those in Group R-I (6.9 ± 0.9 cm H₂O•cm^-1) (P < 0.01) and in Group R-II (12.4 ± 3.1 cm H₂O•cm^-1) (P < 0.01), respectively.

Conclusion: The BCP decreased in both of the Mallinckrodt and Rüsch DLTs, and the rates of decrease of the former were greater than those of the latter.

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