Users Online: 2183 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Login 

RSACP wishes to inform that it shall be discontinuing the dispatch of print copy of JOACP to it's Life members. The print copy of JOACP will be posted only to those life members who send us a written confirmation for continuation of print copy.
Kindly email your affirmation for print copies to [email protected] preferably by 30th June 2019.


Table of Contents
Year : 2013  |  Volume : 29  |  Issue : 1  |  Page : 125

Extubation aid in double lumen tube exchange in difficult airway cases operated for thoracic surgeries

Department of Anesthesiology and Intensive Care,Government Medical College and Hospital, Sector 32,Chandigarh, India

Date of Web Publication10-Jan-2013

Correspondence Address:
Manpreet Singh
Department of Anesthesiology and Intensive Care, Government Medical College and Hospital, Sector 32, Chandigarh
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-9185.105823

Rights and Permissions

How to cite this article:
Singh M, Kapoor D, Singh J. Extubation aid in double lumen tube exchange in difficult airway cases operated for thoracic surgeries. J Anaesthesiol Clin Pharmacol 2013;29:125

How to cite this URL:
Singh M, Kapoor D, Singh J. Extubation aid in double lumen tube exchange in difficult airway cases operated for thoracic surgeries. J Anaesthesiol Clin Pharmacol [serial online] 2013 [cited 2021 Jun 22];29:125. Available from:


Double lumen tube (DLT) is used in thoracic surgical procedures. A majority of these surgeries mandate postoperative elective ventilation. It is a common practice that DLT is exchanged with conventional endotracheal tube (ETT) before transferring the patient out of the operating room. [1],[2],[3] The exchange of the tracheal tube requires a fiberscope, which is not available in many operation theaters in developing countries.

In case the airway is not difficult, the DLT is removed and a conventional ETT is placed in the trachea. However, if the patient has a difficult airway, extubation of DLT should be guarded and a ventilating tube exchanger should be used. Commercially available ETT exchangers are usually 70 cm long and thus may not serve the purpose. Gum elastic bougies and hollow tube exchangers are also not enough long to replace DLT. Some extra-long(Cook's DLT exchanger,100 cm length) tube exchangers are available commercially but they are expensive and their availability is limited.

We have successfully used, in 26 cases, a novel indigenous hollow ventilating DLT tube exchanger i.e., 260 cm length, 0.9 mm Bentson exchange guidewire (Cook® , Medical Inc, Bloomington, IN, USA) sheath. This sheath has appropriate length for above purposes and can be utilized for any sized DLT. It is latex-free, safe, flexible, and easily available. These extra-long sheaths cover the guidewires are used in percutaneous nephrolithotomy surgery by urologists.

DLT of adult sizes (37 F, 39 F) are 45 cm long and to exchange them, a 90 cm tube exchanger is required. In difficult airway situations, hollow ventilating exchangers are always better. On its proximal end of this sheath, 4.0 mm ID ETT connector can be easily mounted [Figure 1], which can be utilized for oxygenation or ventilation during exchange of tubes.
Figure 1: Bentson exchange guidewire sheath with ETT No. 4.00 connector mounted

Click here to view

  References Top

1.Burk WJ III: Should a fiberoptic bronchoscope be routinely used to position a double-lumen tube (letter)? Anesthesiology 1988;68:826-7.  Back to cited text no. 1
2.Hannallah M. Evaluation of tracheal tube exchangers® for replacement of double-lumen endobronchial tubes. Anesthesiology 1992;77:609-10.  Back to cited text no. 2
3.Griffin PR, Mitchell MR, Viswanathan S, Riopelle JM, Campbell CE, Karpan DJ. Use of plastic rod/sleeve combination to facilitate double-to single-lumen tracheal tube exchange in patients with difficult glottic visualization. Anesth Analg 1998;87:74.  Back to cited text no. 3


  [Figure 1]

This article has been cited by
1 Enhanced recovery after surgery: Prediction for early extubation in video-assisted thoracic surgery using a response surface model in anesthesia
Yu-Wei Chiou,Chien-Kun Ting,Hsin-Yi Wang,Mei-Yung Tsou,Wen-Kuei Chang
Journal of the Formosan Medical Association. 2019;
[Pubmed] | [DOI]
2 A previously published propofol–remifentanil response surface model does not predict patient response well in video-assisted thoracic surgery
Hsin-Yi Wang,Chien-Kun Ting,Jing-Yang Liou,Kun-Hui Chen,Mei-Young Tsou,Wen-Kuei Chang
Medicine. 2017; 96(19): e6895
[Pubmed] | [DOI]
3 Comment préférez-vous votre guide ou mandrin pour intuber ? Long ou court, plein ou creux, dur ou mou, droit ou béquillé ?
Patrick Schoettker,Sina Grape
Le Praticien en Anesthésie Réanimation. 2016; 20(6): 271
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
   Article Figures

 Article Access Statistics
    PDF Downloaded335    
    Comments [Add]    
    Cited by others 3    

Recommend this journal