Movements of the double-lumen endotracheal tube due to lateral position with head rotation and tube fixation: a Thiel-embalmed cadaver study
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Following successful double-lumen endotracheal tube (DLT) insertion for pulmonary surgery, the body position of a patient is changed from supine to lateral. This change occasionally leads to the malposition of the DLT and difficulty in differential lung ventilation.
In this study, we investigated movements of the DLT induced by change in body position from supine to lateral, using Thiel-embalmed cadavers. Thiel-embalmed cadavers retain full flexibility of the body and preservation of natural colours, using novel preservation techniques. After the tip of the DLT was directly fixed with forceps at the appropriate position in the bronchus, the DLT depth was measured at the lip in supine and lateral positions.
The depth of DLT insertion measured at the lip in right (25.2 ± 0.3 cm; mean ± SEM) and left (25.1 ± 0.3 cm) lateral positions was significantly increased compared to the supine position (24.7 ± 0.3 cm).
We recommend that the depth of DLT insertion should be advanced by approximately 0.5 cm from the best position, before changing from the supine to lateral position.
KeywordsDouble-lumen endotracheal tube (DLT) Thiel-embalmed cadaver Lateral position Head rotation
The authors wish to thank Prof. Mineko Fujimiya and Dr. Daisuke Suzuki (Second Department of Anatomy, Sapporo Medical University School of Medicine) for providing cadavers and technical advice. In addition, we respect the volunteers who posthumously provided their bodies to medical research without any economic benefit.
Conflict of interest
The authors declare that they have no conflict of interest.
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