University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
University of Bristol Medical School, Bristol, UK.
Anaesthesia. 2019 Jul;74(7):891-895. doi: 10.1111/anae.14672. Epub 2019 May 9.
Tracheal intubation with a double-lumen tube can be more challenging than with a single-lumen tube. A bougie can be used to facilitate intubation. Case reports have described fragment shearing from bougies when they are removed from the tube after intubation. These fragments have the potential to cause harm. It has even been suggested that bougies and double-lumen tubes should not be used together. We conducted a benchtop trial to investigate factors that influence the risk of shearing. We investigated three brands of double-lumen tube (each in three sizes and both lateralities) and four brands of bougie. We simulated one intubation and 29 further insertions/removals of bougie with every bougie-double-lumen tube combination. We inspected the inside of the tube for evidence of shearing after first, tenth and thirtieth removals. We found that brand of bougie, brand of double-lumen tube and size of double-lumen tube (but not its laterality) all influenced the degree of shearing. Certain bougie-double-lumen tube combinations produced a particularly high degree of shearing, so these should be avoided.
经双腔管进行气管插管比单腔管更具挑战性。可使用探条来辅助插管。病例报告描述了在插管后将探条从管内取出时发生的探条断裂碎片。这些碎片有可能造成伤害。甚至有人建议不要将探条和双腔管一起使用。我们进行了一项台架试验，以研究影响断裂风险的因素。我们研究了三种品牌的双腔管（每种品牌有三种尺寸和两种侧孔）和四种品牌的探条。我们模拟了一次插管和 29 次进一步的探条插入/取出操作，每次操作都使用一种探条-双腔管组合。在第一次、第十次和第三十次取出后，我们检查了管内是否有断裂的证据。我们发现，探条的品牌、双腔管的品牌和双腔管的尺寸（但不是其侧孔）都影响了断裂的程度。某些探条-双腔管组合会产生特别高的断裂程度，因此应避免使用这些组合。
