Use of a neck brace minimizes double-lumen tube displacement during patient positioning

Tae Gyoon Yoon, Hye Won Chang, Ho Geol Ryu, Tae Dong Kwon, Jae-Hyon Bahk

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: When patients are moved from the supine to the lateral decubitus position, the double-lumen endobronchial tube (DLT) is often displaced. The aim of this study was to determine whether a DLT is displaced when there are no movements of the head and neck. Methods: One hundred patients scheduled for elective thoracic surgery were randomly divided into control and brace groups. Only a left-sided DLT was used during the study. All patients in the brace group wore a neck collar before the positional change. Using a fibreoptic bronchoscope, the distance from the tracheal opening to the main carina and from the bronchial opening to the bronchial carina was measured in the supine and lateral decubitus positions. Results: Displacement of the DLT (mean ± SD) during a change from the supine to the lateral decubitus position was greater in the control group (6.3 ± 5.5 mm in the trachea; 2.4 ± 3.6 mm in the bronchus) than in the brace group (2.2 ± 3.9 mm in the trachea; 0.6 ± 3.1 mm in the bronchus); (P < 0.001). The incidence of clinically significant displacement, greater than 5 mm from the initial correct position, was higher in the control group than in the brace group (48% vs 12%, P < 0.001). Conclusion: By restricting head and neck movements with a neck brace, the DLT displacement could be minimized while positioning patients for thoracotomy. The main cause of the DLT displacement during lateral positioning appears to be related to movement of the head and neck.

Original languageEnglish
Pages (from-to)413-417
Number of pages5
JournalCanadian Journal of Anesthesia
Volume52
Issue number4
DOIs
StatePublished - 1 Jan 2005

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Patient Positioning
Braces
Neck
Head Movements
Bronchi
Trachea
Control Groups
Bronchoscopes
Thoracotomy
Thoracic Surgery
Incidence

Cite this

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title = "Use of a neck brace minimizes double-lumen tube displacement during patient positioning",
abstract = "Purpose: When patients are moved from the supine to the lateral decubitus position, the double-lumen endobronchial tube (DLT) is often displaced. The aim of this study was to determine whether a DLT is displaced when there are no movements of the head and neck. Methods: One hundred patients scheduled for elective thoracic surgery were randomly divided into control and brace groups. Only a left-sided DLT was used during the study. All patients in the brace group wore a neck collar before the positional change. Using a fibreoptic bronchoscope, the distance from the tracheal opening to the main carina and from the bronchial opening to the bronchial carina was measured in the supine and lateral decubitus positions. Results: Displacement of the DLT (mean ± SD) during a change from the supine to the lateral decubitus position was greater in the control group (6.3 ± 5.5 mm in the trachea; 2.4 ± 3.6 mm in the bronchus) than in the brace group (2.2 ± 3.9 mm in the trachea; 0.6 ± 3.1 mm in the bronchus); (P < 0.001). The incidence of clinically significant displacement, greater than 5 mm from the initial correct position, was higher in the control group than in the brace group (48{\%} vs 12{\%}, P < 0.001). Conclusion: By restricting head and neck movements with a neck brace, the DLT displacement could be minimized while positioning patients for thoracotomy. The main cause of the DLT displacement during lateral positioning appears to be related to movement of the head and neck.",
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Use of a neck brace minimizes double-lumen tube displacement during patient positioning. / Yoon, Tae Gyoon; Chang, Hye Won; Ryu, Ho Geol; Kwon, Tae Dong; Bahk, Jae-Hyon.

In: Canadian Journal of Anesthesia, Vol. 52, No. 4, 01.01.2005, p. 413-417.

Research output: Contribution to journalArticle

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AU - Chang, Hye Won

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N2 - Purpose: When patients are moved from the supine to the lateral decubitus position, the double-lumen endobronchial tube (DLT) is often displaced. The aim of this study was to determine whether a DLT is displaced when there are no movements of the head and neck. Methods: One hundred patients scheduled for elective thoracic surgery were randomly divided into control and brace groups. Only a left-sided DLT was used during the study. All patients in the brace group wore a neck collar before the positional change. Using a fibreoptic bronchoscope, the distance from the tracheal opening to the main carina and from the bronchial opening to the bronchial carina was measured in the supine and lateral decubitus positions. Results: Displacement of the DLT (mean ± SD) during a change from the supine to the lateral decubitus position was greater in the control group (6.3 ± 5.5 mm in the trachea; 2.4 ± 3.6 mm in the bronchus) than in the brace group (2.2 ± 3.9 mm in the trachea; 0.6 ± 3.1 mm in the bronchus); (P < 0.001). The incidence of clinically significant displacement, greater than 5 mm from the initial correct position, was higher in the control group than in the brace group (48% vs 12%, P < 0.001). Conclusion: By restricting head and neck movements with a neck brace, the DLT displacement could be minimized while positioning patients for thoracotomy. The main cause of the DLT displacement during lateral positioning appears to be related to movement of the head and neck.

AB - Purpose: When patients are moved from the supine to the lateral decubitus position, the double-lumen endobronchial tube (DLT) is often displaced. The aim of this study was to determine whether a DLT is displaced when there are no movements of the head and neck. Methods: One hundred patients scheduled for elective thoracic surgery were randomly divided into control and brace groups. Only a left-sided DLT was used during the study. All patients in the brace group wore a neck collar before the positional change. Using a fibreoptic bronchoscope, the distance from the tracheal opening to the main carina and from the bronchial opening to the bronchial carina was measured in the supine and lateral decubitus positions. Results: Displacement of the DLT (mean ± SD) during a change from the supine to the lateral decubitus position was greater in the control group (6.3 ± 5.5 mm in the trachea; 2.4 ± 3.6 mm in the bronchus) than in the brace group (2.2 ± 3.9 mm in the trachea; 0.6 ± 3.1 mm in the bronchus); (P < 0.001). The incidence of clinically significant displacement, greater than 5 mm from the initial correct position, was higher in the control group than in the brace group (48% vs 12%, P < 0.001). Conclusion: By restricting head and neck movements with a neck brace, the DLT displacement could be minimized while positioning patients for thoracotomy. The main cause of the DLT displacement during lateral positioning appears to be related to movement of the head and neck.

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