Improvement of Twin-lumer Endotracheal Tube with Carinal Hook for Safety of One-lung Anesthesia

Abstract

Hypoxemia was seen during one-lung anesthesia because of the obstruction of the left upper lobe bronchus by the bronchial branch of a double-lumen tube. The cause is the long distance between carinal hook and tip of twin-lumen endotracheal tube(Portex). Therefore we cut a bevel of twin-lumen endotracheal tube rectangularly. As a result, blood gas deterioration during one-lung anesthesia decreased from 14 to 0%, However, impossibility to separate the two lungs increased from 0 to 7.5%. There were morphological changes of trachea and/or branchus in all cases not separating the lungs.