Deciding how to decide the correct double-lumen tube: a narrative review of methods and evidence.
Authors
Affiliations (6)
Affiliations (6)
- Anesthesia and Intensive Care Unit, AO Dei Colli-Monaldi Hospital, Naples, Italy.
- School of Anesthesia and Intensive Care, Humanitas University, Pieve Emanuele, Italy.
- Anesthesia and Perioperative Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
- Anesthesia and Intensive Care, Dipartimento Di Anestesia, Rianimazione Ed Emergenze, AOU Città Della Salute E Della Scienza, Turin, Italy.
- Division of Anesthesiology, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy. [email protected].
Abstract
The selection of the appropriate size of a double-lumen tube (DLT) is a critical yet often underestimated aspect of thoracic anaesthesia. The present narrative review evaluates traditional and emerging methods for determining DLT size, including anthropometric formulas, chest X-rays, CT scans, and ultrasonography. Despite the prevalence of height- and gender-based predictions, mounting evidence underscores their restricted correlation with airway anatomy. Chest X-rays and CT scans have been shown to offer more accurate estimations of tracheobronchial dimensions, while ultrasound has been identified as a promising bedside tool. Recent meta-analytic evidence and technological advancements, including 3D reconstruction and AI-based modelling, may support a more personalised and safer approach. It is recommended that a pragmatic, image-guided strategy be employed to minimise airway trauma, improve lung isolation, and optimise patient outcomes.