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Canadian Journal of Anesthesia

, Volume 52, Issue 4, pp 413–417 | Cite as

Use of a neck brace minimizes double-lumen tube displacement during patient positioning

  • Tae-Gyoon Yoon
  • Ho-Geol Ryu
  • Tae-Dong Kwon
  • Jae-Hyon BahkEmail author
  • Hye-Won Chang
Cardiothoracic anesthesia, respiration and airway

Abstract

Purpose

When patients are moved from the supine to the lateral decubitus position, the double-lumen endobronchial tube (DLT) is often displaced. The aim of this study was to determine whether a DLT is displaced when there are no movements of the head and neck.

Methods

One hundred patients scheduled for elective thoracic surgery were randomly divided into control and brace groups. Only a left-sided DLT was used during the study. All patients in the brace group wore a neck collar before the positional change. Using a fibreoptic bronchoscope, the distance from the tracheal opening to the main carina and from the bronchial opening to the bronchial carina was measured in the supine and lateral decubitus positions.

Results

Displacement of the DLT (mean ± SD) during a change from the supine to the lateral decubitus position was greater in the control group (6.3 ± 5.5 mm in the trachea; 2.4 ± 3.6 mm in the bronchus) than in the brace group (2.2 ± 3.9 mm in the trachea; 0.6 ± 3.1 mm in the bronchus); (P < 0.001). The incidence of clinically significant displacement, greater than 5 mm from the initial correct position, was higher in the control group than in the brace group (48% vs 12%, P < 0.001).

Conclusion

By restricting head and neck movements with a neck brace, the DLT displacement could be minimized while positioning patients for thoracotomy. The main cause of the DLT displacement during lateral positioning appears to be related to movement of the head and neck.

Objectif

Quand les patients sont changés de position, du décubitus dorsal à latéral, le tube endobronchique à double lumière (TDL) est souvent déplacé. Notre but était de découvrir si un TDL est déplacé quand il n’y a aucun mouvement de la tête et du cou.

Méthode

Cent patients devant subir une intervention chirurgicale thoracique réglée ont été répartis en groupes témoin et collet cervical (CC). Seul un TDL gauche a été utilisé. Tous les patients du groupe CC portaient un collet cervical avant le changement de position. à l’aide d’un fibroscope bronchique, la distance entre l’ouverture de la trachée et la carène principale et entre l’ouverture bronchique et la carène bronchique a été mesurée en décubitus dorsal et latéral.

Résultats

Le déplacement du TDL (moyenne ± écart type) pendant un changement de position, du décubitus dorsal à latéral, a été plus grand dans le groupe témoin (6,3 ± 5,5 mm dans la trachée; 2,4 ± 3,6 mm dans la bronche) que dans le groupe CC (2,2 ± 3,9 mm dans la trachée ; 0,6 ± 3,1 mm dans la bronche); (P < 0,001). L’incidence d’un déplacement cliniquement significatif, plus grand que 5 mm de la position initiale correcte, a été plus élevée dans le groupe témoin que dans le groupe CC (48 % vs12 %, P < 0,001). asConclusion

En restreignant les mouvements de la tête et du cou avec un collet cervical, le déplacement du TDL peut être minimisé quand on installe les patients pour la thoracotomie. La principale cause de déplacement du TDL chez le patient en décubitus latéral semble reliée au mouvement de la tête et du cou.

Keywords

Lateral Decubitus Position Fibreoptic Bronchoscope Tracheal Lumen Bronchial Blocker Neck Collar 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
[L’usage d’un collet cervical réduit le déplacement du tube à double lumière pendant le positionnement du patient]

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Copyright information

© Canadian Anesthesiologists 2005

Authors and Affiliations

  • Tae-Gyoon Yoon
    • 1
  • Ho-Geol Ryu
    • 1
  • Tae-Dong Kwon
    • 1
  • Jae-Hyon Bahk
    • 1
    Email author
  • Hye-Won Chang
    • 2
  1. 1.Department of AnesthesiologySeoul National University Hospital, Seoul National University College of MedicineChongno-GuKorea
  2. 2.Seoul National University College of Medicine; and the Kangnam Saint Mary’s HospitalThe Catholic University of KoreaSeoulKorea

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