Wei-Lin Lin1, Chen-Hwan Cherng2. 1. Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan. 2. Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan. Electronic address: cherng1018@yahoo.com.tw.
Abstract
OBJECTIVE: Appropriate placement of the double-lumen endobronchial tube (DLT) is essential for one-lung ventilation. Several formulae based on body height (BH) have been used for estimating the optimal insertion depth of a left-sided DLT. In this study, the authors examined the following 5 formulae for accuracy of prediction: 0.11×BH+10.53 (cm) from Brodsky et al(1); 0.15×BH+3.96 (cm) from Bahk and Oh(2); 0.148×BH+3.8 (cm) from Chow et al;(3) 0.1×BH+12.5 (cm) from Takita et al(4); and 0.1977×BH - 4.2423 (cm) (authors' formula). DESIGN: Single-center, retrospective, observational study. SETTING: University hospital. PARTICIPANTS: Anesthetic records of patients older than 20 years who received one-lung ventilation using a left-sided DLT were included. INTERVENTIONS: The patients' sex, age, body weight, BH, and the final correct insertion depth of the left-sided DLT after fiberscope verification were recorded. Linear regression and correlation were used to analyze the data. MEASUREMENTS AND MAIN RESULTS: One hundred seventy anesthetic records were analyzed. The insertion depth was distributed normally in 4 groups with different BH intervals. The correlations between the correct insertion depth and all the lengths calculated using each formula were significant (p<0.001), with a similar high coefficient of determination (r = 0.809). The regression line derived from the authors' formula-0.1977×BH - 4.2423 (cm)-showed the most accuracy in predicting the correct insertion depth. CONCLUSIONS: The height-based formula of 170 - 29.5 - 5 - 1 (the insertion depth is 29.5 cm for patients who are 170 cm tall, and the insertion length is increased or decreased by 1 cm for every 5 cm increase or decrease in BH) modified by the equation of 0.1977×BH - 4.2423 is a useful tool to predict the optimal insertion depth in initially blind left-sided DLT insertion.
OBJECTIVE: Appropriate placement of the double-lumen endobronchial tube (DLT) is essential for one-lung ventilation. Several formulae based on body height (BH) have been used for estimating the optimal insertion depth of a left-sided DLT. In this study, the authors examined the following 5 formulae for accuracy of prediction: 0.11×BH+10.53 (cm) from Brodsky et al(1); 0.15×BH+3.96 (cm) from Bahk and Oh(2); 0.148×BH+3.8 (cm) from Chow et al;(3) 0.1×BH+12.5 (cm) from Takita et al(4); and 0.1977×BH - 4.2423 (cm) (authors' formula). DESIGN: Single-center, retrospective, observational study. SETTING: University hospital. PARTICIPANTS: Anesthetic records of patients older than 20 years who received one-lung ventilation using a left-sided DLT were included. INTERVENTIONS: The patients' sex, age, body weight, BH, and the final correct insertion depth of the left-sided DLT after fiberscope verification were recorded. Linear regression and correlation were used to analyze the data. MEASUREMENTS AND MAIN RESULTS: One hundred seventy anesthetic records were analyzed. The insertion depth was distributed normally in 4 groups with different BH intervals. The correlations between the correct insertion depth and all the lengths calculated using each formula were significant (p<0.001), with a similar high coefficient of determination (r = 0.809). The regression line derived from the authors' formula-0.1977×BH - 4.2423 (cm)-showed the most accuracy in predicting the correct insertion depth. CONCLUSIONS: The height-based formula of 170 - 29.5 - 5 - 1 (the insertion depth is 29.5 cm for patients who are 170 cm tall, and the insertion length is increased or decreased by 1 cm for every 5 cm increase or decrease in BH) modified by the equation of 0.1977×BH - 4.2423 is a useful tool to predict the optimal insertion depth in initially blind left-sided DLT insertion.
Authors: Sung Hye Byun; Su Hwang Kang; Jong Hae Kim; Taeha Ryu; Baek Jin Kim; Jin Yong Jung Journal: Medicine (Baltimore) Date: 2016-08 Impact factor: 1.889