학술논문
Effect of Minimum Bronchial Cuff Volume of Left-Sided Double-Lumen Tube for One-Lung Ventilation on the Change in Bronchial Cuff Pressure during Lateral Positioning in Thoracic Surgery: A Prospective Observational Study.
Document Type
Academic Journal
Author
Do YW; Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, 807, Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea.; Kim JH; Department of Anesthesiology and Pain Medicine, School of Medicine, Daegu Catholic University, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Republic of Korea.; Kim K; Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, 807, Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea.; Oh J; Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, 807, Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea.; Kwak KH; Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, 807, Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea.; Jeon Y; Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, 130, Dongdeok-ro, Jung-gu, Daegu 41944, Republic of Korea.; Byun SH; Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, 807, Hoguk-ro, Buk-gu, Daegu 41404, Republic of Korea.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2077-0383
Abstract
The minimum bronchial cuff volume (BCVmin) of a double-lumen tube (DLT) without air leaks during lung isolation may vary among individuals, and lateral positioning could increase the bronchial cuff pressure (BCP). We investigated the effect of initially established BCVmin (BCVi) on the change in BCP by lateral positioning. Seventy patients who underwent elective lung surgery were recruited and divided into two groups according to the BCVi obtained during anesthetic induction in each patient. Outcome analysis was conducted using data from 39 patients with a BCVi greater than 0 (BCVi > 0 group) and 27 with a BCVi of 0 (BCVi = 0 group). The primary outcome was a change in the value measured in the supine and lateral positions of the initially established BCP (BCPi; BCP at the time of BCVi injection), which was significantly larger in the BCVi > 0 group than in the BCVi = 0 group (1.5 (0.5-6.0) cmH 2 O vs. 0.0 (0.0-1.0) cmH 2 O; p < 0.001). BCVi was related to the left main bronchus (LMB) diameter (Spearman's rho = 0.676, p < 0.001) and the gap between the LMB diameter and the outer diameter of the bronchial cuff (Spearman's rho = 0.553, p < 0.001). Therefore, selecting a DLT size with a bronchial cuff that fits each patient's LMB may be useful in minimizing the change in BCP when performing lateral positioning during thoracic surgery. If the bronchial cuff requires unavoidable initial inflation, it is necessary to be aware that BCP may increase during lateral positioning and to monitor the BCP regularly if possible.