Double lumen tube

Adv:

quicker to insert
less prone to displacement
can accommodate the deflation & suctioning of secretions from either lung

Features & design

Modern DLTs are single use, made of polyvinylchloride and are based on the Robertshaw design

DLT sizes are sized using the French (Fr) gauge system, where 1 Fr=1/3 mm of the outer diameter. Thus, a 37 Fr DLT has an outer diameter of 1/3×37=12.3 mm.

DLT vs BB

Sequence of clinical check

Correct bronchus
- Clamp tracheal lumen
- ventilate bronchial lumen
- → should ventilate left lung
  - if right lung ventilates → DLT in RMB
Correct depth
- Clamp bronchial lumen
- ventilate tracheal lumen
- → right lung easily ventilated
  - if ↑Paw: tracheal lumen obstructed by wall of LMB
    - → need shift out
  - if both lungs ventilate → too far out
    - → need shift in
Bronchoscopy

References

Double-Lumen Tubes and Bronchial Blockers - BJA Ed

How to Choose the Double-Lumen Tube Size and Side