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Bronchial cuff pressure change caused by left-sided double-lumen endobronchial tube displacement

Abstract

Purpose: The bronchial cuff pressures (BCPs) of left-sided double-lumen endobronchial tubes (DLTs) manufactured by Rüsch and Mallinckrodt were measured in 80 patients when the tubes were withdrawn to compare the effect of tube design on BCP change.

Methods: During general anesthesia with muscle relaxation, the cephalad surface of the endobronchial cuff was positioned either 2.5 cm distal to the carina (Rüsch Group R-I; n=20 and Mallinckrodt Group B-I; n=20) or just below the carina (Rüsch Group R-II; n=20 and Mallinckrodt Group B-II; n=20) and the cuff was inflated to 35 cm H2O. The tube was then withdrawn in 0.5-cm steps until the cuff was 2.0 cm proximal to the carina, the position just before the capnogram or pressure-volume loop of tracheal lumen changed. The BCP at each step was measured. The rate of decrease in BCP was defined as the decrease of BCP divided by the length of displacement of DLT.

Results: The rates of decrease from the +2.5 cm position to the end point in Group B-I (7.7±0.8 cm H2O·cm−1 and those from the most proximal acceptable position to the end point in Group B-II (19.5±4.8 cm H2O·cm−1 were greater than those in Group R-I (6.9±0.9 cm H2O·cm−1) (P<0.01) and in Group R-II (12.4±3.1 cm H2O·cm−1) (P<0.01), respectively.

Conclusion: The BCP decreased in both of the Mallinckrodt and Rüsch DLTs, and the rates of decrease of the former were greater than those of the latter.

Résumé

Objectif: Les pressions du ballonnet bronchique (PBB) des tubes à double lumière (TDL) gauches fabriqués par Rüsch et Mallinckrodt ont été mesurées chez 80 patients au moment du retrait des tubes afin de comparer l’effet du design du tube sur le changement de PBB.

Méthode: Pendant l’anesthésie générale avec myorelaxant, la partie supérieure du ballonnet endobronchique a été placée soit à 2,5 cm sous la carène (groupe Rüsch R-I; n=20 et groupe Mallinckrodt B-I; n=20), soit juste sous la carène (groupe Rüsch R-II; n=20 et groupe Mallinckrodt B-II; n=20) et le ballonnet a été gonflé jusqu’à obtenir une pression de 35 cm H2O. Le tube a été ensuite retiré par palier de 0,5 cm jusqu’à ce que le ballonnet soit à 2,0 cm au-dessus de la carène, la position occupée juste avant que ne change le capnogramme ou la boucle pression-volume de la lumière trachéale. La PBB a été mesurée à chaque palier. Le taux de baisse de PBB a été défini comme la baisse de PBB divisée par la longueur du déplacement du TDL.

Résultats: Les taux de baisse de pression à partir de la position +2,5 cm jusqu’à la position finale du groupe B-I (7,7±0,8 cm H2O·cm−1) et à partir de la position la plus proximale possible jusqu’à la position finale dans le groupe B-II (19,5±4,8 cm H2O·cm−1) ont été plus hauts que ceux des groupes R-I (6,9±0,9 cm H2O·cm−1) (P<0,01) et R-II (12,4±3,1 cm H2O·cm−1) (P<0,01), respectivement.

Conclusion: La PBB a diminué avec les TDL Mallinckrodt et Rüsch et le taux de baisse avec le premier a été plus marqué qu’avec le deuxième.

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Correspondence to Kazukuni Araki MD.

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Araki, K., Nomura, R., Urushibara, R. et al. Bronchial cuff pressure change caused by left-sided double-lumen endobronchial tube displacement. Can J Anesth 47, 775–779 (2000). https://doi.org/10.1007/BF03019480

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Keywords

  • Tracheal Lumen
  • Bronchial Cuff
  • Endobronchial Cuff
  • Tracheal Blood Flow
  • Large Volume Cuff