Observational studyBMC anesthesiology2024
Common double-lumen tube selection methods overestimate adequate tube sizes in individual patients - a 3D reconstruction study.
Observational study in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Role of High-Resolution Computed Tomography in Double-Lumen Tube Selection for Patients Undergoing Minimally Invasive Coronary Bypass.Journal of clinical medicine · 2026Article
- Gravity-driven modified whole-lung lavage improves procedural efficiency in pulmonary alveolar proteinosis.Journal of thoracic disease · 2026Article
- Comprehensive Tracheobronchial Morphometry in Korean Adults: Clinical Implications for Double-Lumen Tube Sizing and Right Upper Lobe Alignment.Journal of clinical medicine · 2026Article
- Deciding how to decide the correct double-lumen tube: a narrative review of methods and evidence.Journal of anesthesia, analgesia and critical care · 2025Review
- Prospective in-depth analysis of anaesthetic management of spontaneous ventilation VATS for lung cancer resection: a matched pairs comparison to intubated VATS.BMC anesthesiology · 2025Article
- Impact of cardiac factors on central airway anatomical parameters in patients undergoing lung mass surgery.Journal of cardiothoracic surgery · 2025Article
- A Recently Patented Sleeve-Type Endotracheal Tube: Innovative Design and Clinical Prospects for Improving One-Lung Ventilation.Medical devices (Auckland, N.Z.) · 2025Review
- Impact of double lumen tube length variations on lung isolation: A clinical observation.Journal of anaesthesiology, clinical pharmacologyArticle
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAppropriate selection of double-lumen tube sizes for one-lung ventilation is crucial to prevent airway damage. Current selection methods rely on demographic factors or 2D radiography. Prediction of left bronchial diameter is indispensable for choosing the adequate tube size. This prospective observational study investigates if current selection methods sufficiently predict individuals' left bronchial diameters for DLT selection compared to the 3D reconstruction.
methods100 patients necessitating thoracic surgery with one-lung ventilation and left-sided double-lumen tubes, ≥ 18 years of age, and a set of chest X-rays and 2D thorax CT scans for 3D reconstruction of the left main bronchus were included between 07/2021 and 06/2023. The cross-validated prediction error and the width of the 95%-prediction intervals of the 3D left main bronchial diameter utilizing linear prediction models were based on current selection methods.
resultsThe mean bronchial diameter in 3D reconstruction was 13.6 ± 2.1 mm. The ranges of the 95%-prediction intervals for the bronchial diameter were 6.4 mm for demographic variables, 8.3 mm for the tracheal diameter from the X-ray, and 5.9 mm for bronchial diameter from the 2D-CT scans. Current methods violated the suggested '≥1 mm' safety criterion in up to 7% (men) and 42% (women). Particularly, 2D radiography overestimated women's left bronchial diameter. Current methods even allowed the selection of double-lumen tubes with bronchial tube sections greater than the bronchial diameter in women.
conclusionsNeither demographic nor 2D-radiographic methods sufficiently account for the variability of the bronchial diameter. Wide 95%-prediction intervals for the bronchial diameter hamper accurate individual double-lumen tube selection. This increases women's risk of bronchial damage, particularly if they have other predisposing factors. These patients may benefit from 3D reconstruction of the left main bronchus.
trial registrationNot applicable.
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