Cependant, ces sondes se déplacent habituellement au cours d’un changement de position en decubitus latéral en raison d’une extension du cou. La bonne position des sondes à doubles lumières (DLT) est d’ordinaire confirmée par bronchoscopie après intubation trachéale chez un patient en decubitus dorsal avec appuie-tête. Correct adjustment of DLT position without a headrest in the supine position is an easy and effective method to minimize DLT displacement during lateral positioning ( number, NCT01413347).
Conclusionĭisplacement of DLTs during lateral positioning appears to be caused primarily by extension of the neck.
Resultsĭisplacement of DLTs during lateral positioning was greater in the headrest group than in the no-headrest group [12.3 (6.5) mm vs 6.8 (5.5) mm, respectively, in the trachea 11.6 (6.7) mm vs 6.0 (4.6) mm, respectively, in the bronchus P 10 mm from initial correct position, was greater in the headrest group than in the no-headrest group (64% vs 28%, respectively, in the trachea 58% vs 20%, respectively, in the bronchus P < 0.001). Using a bronchoscope, distances from the tracheal opening to the main carina and from the bronchial opening to the left bronchial carina were measured in both the supine and lateral positions. After tracheal intubation using a headrest, adjustment of DLT position was performed according to group assignment, i.e., either with the headrest in place or without the headrest. One hundred patients scheduled for thoracic surgery were randomized into two groups ( n = 50 each). This study was undertaken to determine whether displacement of DLTs could be minimized during lateral positioning if DLTs were positioned without a headrest. However, displacement of DLTs usually occurs during lateral positioning because of neck extension.
The correct position of double-lumen tubes (DLTs) is customarily confirmed after tracheal intubation by bronchoscopy with the patient supine on a headrest.
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