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How to calculate the insertion depth of double-lumen endobronchial tube in thoracic surgery?

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Update time : 2021-06-10 15:52:14
How to calculate the insertion depth of double-lumen endobronchial tube in thoracic surgery?

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Calculating the insertion depth of the double lumen endobronchial tube is not very helpful for the operation. Everyone's situation is different, and it has a certain relationship with the height, and it also has a relationship with the dual-lumen endobronchial tube itself.

Generally, the type of double lumen endobronchial tube used by men is between Fr29-Fr31, and women are between Fr27-Fr29. Without considering the problem of the right tube blocking the right upper lung opening, moving up and down 1 cm does not have much isolation effect. influences.

Sometimes the angle of entry into the glottis is too large, and it is necessary to rotate and change the direction of the supervisor to pass the glottis. No matter how it rotates, after the main pipe enters the glottis, it should be rotated back in the opposite direction according to the original rotation path to avoid the side hole deviation. While ensuring that the tube is in the right position, send the tube downward and stop when you feel a slight resistance. Generally, an anesthesiologist with sensation on the hand, as long as it is not anatomical variation, is 80% sure that the placement is successful at one step.

Then double-pipe ventilation, listen to the breath sounds and look at the airway pressure. Only the side breathing sound of the main pipe is heard, indicating that it is deep, retreat 1cm, and repeat this step; only the side pipe breathing sound is heard, indicating that you have entered the wrong bronchus and retreated to the main bronchus. Insert, repeat this step; auscultate both lungs as normal, and proceed to the next step.

Clamp the side tube to listen to the breath sound, both sides can hear it, indicating that it is shallow, and then enter 1cm, repeat this step; only the supervisor's breathing sound can be heard, ok, go to the next step.

Clamp the main pipe to listen to the breathing sound of the side tube, and move it up and down in a small range to the standard that the side tube can hear the breathing sound to complete the auscultation positioning.