DOUBLE LUMEN INTUBATION

RELIABILITY OF AUSCULTATORY METHOD?

Abstract

Introduction: Auscultation is well established and most commonly used method for checking of correct placement of
Double Lumen Tube(DLT). Now with widespread availability of fibre optic bronchoscope, confirmation of DLT placement by fibre optic
bronchoscope is recommended by many and considered mandatory by some anaesthetist. Objective: To discuss method of insertion and
reliability of auscultatory method to confirm correct placement of double lumen tubes. S t u d y d e s i g n : Observational. Place a n d d u r a t i o n:
Combined Military Hospital Rawalpindi from 16th Nov 2003 to 13th July 2007. Material & M e t h o d s . We have performed about one thousand
one hundred and fifty double lumen intubation without use of fibreoptic bronchoscope. Results: 85% of patients did not need any tube
adjustment during surgical procedure. Only 15% cases required tube adjustment intra-operatively. None of procedures were abandoned
due to double lumen tubes problems. C o n c l u s i o n : We conclude that auscultation is not that unreliable though not perfect method of DLT
placement. Use of fibreoptic bronchoscope is recommended but not mandatory for DLT placement. Anatomical malpositioning detected by
fibre optic bronchoscope which according to some studies is 70 to 80% does not necessarily translate into physiological malfunctioning.