Evaluate the Accuracy and Effectiveness of Bronchoscopy in Confirming the Proper Positioning of Double-Lumen Endotracheal Tubes (Dlts) In Patients Undergoing Thoracic Surgery for Lung Isolation.

Autor: Jain, Nimish, Sethia, Soumya, Gupta, Parul, Jingar, Hemant, Saxena, Dipti, Khan, Munir Ahmad, Jain, Amisha, Goel, Ankur
Předmět:
Zdroj: European Journal of Cardiovascular Medicine; 2024, Vol. 14 Issue 1, p1076-1082, 7p
Abstrakt: Background: This study seeks to evaluate the accuracy and reliability of bronchoscopy in confirming the correct positioning of double-lumen endotracheal tubes (DLTs) in patients undergoing thoracic surgery. Accurate DLT placement is crucial for lung isolation. This research employs bronchoscopy as a diagnostic tool to validate DLT positioning and assess its effectiveness in clinical practice. Methods: Our study included 30 adult patients undergoing thoracic surgery, which required the use of left-sided double-lumen endobronchial tubes. Anesthesia was induced with propofol, fentanyl, and midazolam as per body weight. Neuromuscular blockade was achieved with vecuronium and patients were ventilated with oxygen for 3mins. The adequate size of the left-sided double-lumen endobronchial tube (Portex sizes 35, 37, 39, and 41) was introduced. Confirmation of DLT placement was assessed initially by auscultation of the desired side of the lung by isolating it, capnography, and movement of the chest wall. Also, moisture during exhalation in the transparent proximal limb of DLT and on the catheter mount was noted. Results: Among 30 patients studied 9 were females and 21 were males. Surgery performed included 10 Lobectomy, 2 Pneumonectomies, 1 Tumor excision, 14 Decortication (in Tubercular Cases), 1 Diaphragmatic Plication, 1 hydatid Cyst Excision, 1 Fungal Ball Removal. Among all the above patients Right Thoracotomy was performed in 19 patients and 11 had left thoracotomy. In all the patients studied left left-sided double-lumen tubes (DLT) (Sizes-35, 37, 39, 41 fr) were used. Of the sample studied (30 Patients), 9 were female and 21 were males. Out of 30 cases studied desired lung isolation was achieved in 26 cases on clinical evaluation (auscultation and chest expansion), in 4 cases DLT was not giving satisfactory results on clinical evaluation and DLT was repositioned properly using the bronchoscope. Conclusion: Bronchoscopy emerged as an invaluable tool in our study, enabling visualization of key anatomical landmarks and identification of complications such as bronchial cuff herniation and deep tube placement. Prompt intervention under direct vision allowed for the correction of these issues, ensuring proper tube placement and minimizing the risk of complications such as inadequate lung isolation or airway trauma. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index