Chow M Y, Liam B L, Thng C H, Chong B K
Department of Anesthesia, Singapore General Hospital and Tan Tock Seng Hospital, Singapore.
Anesth Analg. 1999 Feb;88(2):302-5. doi: 10.1097/00000539-199902000-00014.
We investigated the use of chest computer tomographic (CT) scan measurement of the left mainstem bronchial diameter to predict the correct left-sided double-lumen endobronchial tube (DLT) size in Asian patients who may require smaller DLT sizes. Fifty consecutive Asian adults aged 17-80 yr with preoperative chest CT scans undergoing elective thoracic surgery were entered into the study. The measurements of the left main bronchus diameter were made by using the electronic calipers of the spiral scanner to the nearest millimeter. The sizes of DLT selected were 32F, 35F, 37F, 39F, and 41F for left main bronchus diameters of <10 mm, 10 mm, 11 mm, 12 mm, and >12 mm, respectively. All DLT placements were confirmed and positioned by using fiberoptic bronchoscopy. The tracheas of all patients were successfully intubated with the predicted DLT sizes. Thirty-four patients (68%) were predicted to require smaller DLTs (37F or smaller). Six patients were correctly predicted to receive 32F DLTs. Twelve patients (24%) received an oversized DLT, but none received an undersized DLT. The overall positive predictive value for the male and female patients was 84.4% and 61.1%, respectively. Our study showed that CT scan measurements of the diameter of the left bronchus were especially useful in choosing smaller DLTs.
We used computer tomographic scans to measure the diameter of the left mainstem bronchus, then selected the size of the left-sided double-lumen endobronchial tube (DLT) accordingly. We found that we could predict the sizes of the DLT fairly accurately, especially the smaller DLTs.
我们研究了通过胸部计算机断层扫描（CT）测量左主支气管直径，以预测可能需要较小尺寸双腔支气管导管（DLT）的亚洲患者正确的左侧双腔支气管导管尺寸。连续纳入50例年龄在17 - 80岁、术前行胸部CT扫描并接受择期胸外科手术的亚洲成年人进行研究。使用螺旋扫描仪的电子卡尺测量左主支气管直径，精确到毫米。对于左主支气管直径分别<10 mm、10 mm、11 mm、12 mm和>12 mm的患者，选择的DLT尺寸分别为32F、35F、37F、39F和41F。所有DLT的放置均通过纤维支气管镜进行确认和定位。所有患者的气管均成功插入预测尺寸的DLT。34例患者（68%）预计需要较小尺寸的DLT（37F或更小）。6例患者被正确预测需要32F的DLT。12例患者（24%）接受了尺寸过大的DLT，但没有患者接受尺寸过小的DLT。男性和女性患者的总体阳性预测值分别为84.4%和61.1%。我们的研究表明，CT扫描测量左支气管直径在选择较小尺寸的DLT时特别有用。
我们使用计算机断层扫描测量左主支气管直径，然后据此选择左侧双腔支气管导管（DLT）的尺寸。我们发现我们可以相当准确地预测DLT的尺寸，尤其是较小尺寸的DLT。
