This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bussières, J. S. Articles by Soucy, J. Search for Related Content PubMed PubMed Citation Articles by Bussières, J. S. Articles by Soucy, J.

Modified right-sided Broncho-Cath^TM double lumen tube improves endobronchial positioning: a randomized study

[La sonde double-lumière droite modifiée Broncho-Cath^TM améliore le positionnement endobronchique : une étude randomisée]

Jean S. Bussières, MD^*, Yves Lacasse, MD, Dany Côté, MD^*, Michel Beauvais, MD^*, Sophie St-Onge, MD^*, Jérôme Lemieux, MD^* and Julie Soucy, PhD^*

^* From the Departments of Anesthesiology, and
Pneumology, Laval University Heart and Lung Institute, Laval Hospital, Québec City, Québec, Canada.

Address correspondence to: Dr. Jean S. Bussières, Department of Anesthesiology, Laval Hospital, 2725, Chemin Ste-Foy, Ste-Foy, Québec G1V 4G5, Canada. Phone: 418-656-8711; Fax: 418-656-4637; E-mail: jean.bussieres{at}anr.ulaval.ca

Objective: A left-sided double lumen tube is recommended for one-lung ventilation for most thoracic surgeries, but for certain indications, a right-sided double lumen tube (R-DLT) may be mandatory. Frequent malposition of R-DLTs has been reported. We propose an innovative modification of Mallinckrodt’s Broncho-Cath^TM R-DLT consisting of an enlarged area of the lateral orifice, and studied the impact of this modification on the adequacy of R-DLT positioning.

Methods: Eighty adult patients scheduled for elective thoracic surgery were randomized into two groups: standard Broncho-Cath^TM R-DLT, or modified Broncho-Cath^TM R-DLT. After induction of anesthesia, the R-DLT was positioned using a fibreoptic bronchoscope. The position of the R-DLT was assessed on three occasions: with the patient supine (T1), then immediately following the patient’s transfer to the lateral position (T2), and after repositioning of the tube, when needed, with the patient in lateral position (T3). A score ranging from 1 to 4 was accorded to the relative position of the right upper lobe (RUL) orifice in relation to the origin of the RUL bronchus.

Results: The modified Broncho-Cath^TM R-DLT was more frequently in an adequate position at T2: 77% vs 37% of patients (P = 0.0121), and easier to reposition at T3: 97% vs 74% of patients (P = 0.0109) in comparison to the standard Broncho-Cath^TM R-DLT group.

Conclusion: These data suggest the superiority of the modified Broncho-Cath^TM R-DLT compared to a standard Broncho-Cath^TM R-DLT for optimal R-DLT positioning to facilitate one-lung ventilation during thoracic surgery.

This article has been cited by other articles:

				J. Lohser Tension Pneumothorax During One-Lung Ventilation Anesth. Analg., May 1, 2008; 106(5): 1590 - 1590. [Full Text] [PDF]

				M. Fischler A call to Mallinckrodt for a modified right-sided Broncho-CathTM double lumen tube Can J Anesth, December 1, 2007; 54(12): 1029 - 1030. [Full Text] [PDF]

				J. Lohser, H. S. Umedaly, and B. G. Fitzmaurice Do-it-yourself modified right-sided Broncho-CathTM double lumen tube Can J Anesth, August 1, 2007; 54(8): 675 - 675. [Full Text] [PDF]