Routine Application of Fiberoptic Bronchoscopy in the Positioning of Double-Lumen Endobronchial Tube

Liu Zhang , Huiping Li , Chaoran Wu
Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Center, West-China Hospital of Sichuan University, Chengdu, China.
J Anesth Perioper Med 2018; 5(5): 253- 258 . Published on Sep 28, 2018 . doi:10.24015/JAPM.2018.0091
Author & Article info


Aim of review: This review aimed to present an overview of reports and current opinions regarding the application of fiberoptic bronchoscopy (FOB) in the positioning of double-lumen endobronchial tube (DLT), and to compare the respective merits and demerits of FOB and the blind method.
Methods: Related literature was retrieved from the databases, including PubMed, Embase, Ovid Medline, ScienceDirect, Cochrane databases, and SpringerLink using the keywords of “double lumen tube” or “lung separation” or “one lung ventilation” and “auscultation” combined with “fiberoptic bronchoscopy” from inception to April 1, 2018. The retrieved literature was then carefully read by the authors and summarized with caution. 
Recent findings: The correct position of DLT was of great importance, since a misplaced or improperly used tube could imperil any operation or even lead to a serious catastrophe. However, the conventional blind way still prevailed in most institutions. By contrast, FOB was superior in correctly positioning a DLT, reducing airway injury, shortening the intubation time and contributing to a rapid diagnosis of abnormal ventilation. 
Summary: FOB should be applied as a routine in the positioning of DLT after taking into account the importance of correct DLT positioning in the one-lung ventilation and the potential critical sequelaes induced by the considerable number of malpositions. (Funded by the National Natural Science Foundation of China.)
Citation: Liu Zhang, Huiping Li, Chaoran Wu. Routine Application of Fiberoptic Bronchoscopy in the Positioning of Double-Lumen Endobronchial Tube. J Anesth Perioper Med 2018;5: 253- 258. doi10.24015/JAPM.2018.0091
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