Lung isolation in the morbidly obese patient: a comparison of a left-sided double-lumen tracheal tube with the Arndt® wire-guided blocker

J. H Campos; E. A Hallam; K Ueda

doi:10.1093/bja/aes206

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Lung isolation in the morbidly obese patient: a comparison of a left-sided double-lumen tracheal tube with the Arndt® wire-guided blocker

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Lung isolation in the morbidly obese patient: a comparison of a left-sided double-lumen tracheal tube with the Arndt® wire-guided blocker

J. H Campos, E. A Hallam and K Ueda

British journal of anaesthesia : BJA, Vol.109(4), pp.630-635

10/2012

DOI: 10.1093/bja/aes206

PMID: 22732113

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Abstract

Background Obese patients are at risk of complications during airway management including difficult tracheal intubation. There are no reports regarding the ease of intubation or efficiency of lung collapse with the use of lung isolation devices for the morbidly obese patient. We conducted a prospective, randomized study in morbidly obese patients undergoing one-lung ventilation. We compared the effectiveness and ease of placement of a left-sided double-lumen tube and the Arndt® blocker. Methods Fifty adult patients undergoing thoracic surgery were randomly assigned to a double-lumen tracheal tube (DLT) or standard single-lumen tracheal tube and an Arndt® blocker. The primary endpoint was to record the number of times the tube/devices were successfully positioned at the first attempt and the time spent to achieve optimal position as verified by fibreoptic bronchoscopy. A secondary outcome was the adequacy of lung collapse. Results For the left-sided DLT group, there were three intubation failures on the first attempt. This group required an alternative method with an airway exchange catheter technique to advance the DLT. In the single-lumen tracheal tube with an Arndt® blocker group, there were two intubation failures on the first attempt. After lung isolation devices were placed, lung collapse was clinically comparable in both groups. Conclusions There is no overall advantage of one device over the other during intubation of the morbidly obese patient.

thoracic anaes

equipment, tubes endobronchial

equipment, tubes double-lumen

anatomy, airway

obesity

Details

Title: Subtitle: Lung isolation in the morbidly obese patient: a comparison of a left-sided double-lumen tracheal tube with the Arndt® wire-guided blocker
Creators: J. H Campos - University of Iowa Healthcare
E. A Hallam - University of Iowa Healthcare
K Ueda - University of Iowa Healthcare
Resource Type: Journal article
Publication Details: British journal of anaesthesia : BJA, Vol.109(4), pp.630-635
DOI: 10.1093/bja/aes206
PMID: 22732113
NLM abbreviation: Br J Anaesth
ISSN: 0007-0912
eISSN: 1471-6771
Publisher: Oxford University Press
Language: English
Date published: 10/2012
Academic Unit: Anesthesia
Record Identifier: 9984007165902771

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