Abstract
During fiber-optic bronchoscopy (FOB)-guided intubation, we sometimes found it difficult to insert a tracheal tube into the trachea. If we forced to the tube in, we could damage the bronchoscope. To solve this problem, we suggested the strategy using a guide wire and the tube exchanger. We advanced the FOB into the trachea and inserted a guide wire (0.038 inch Radiforcus, TERUMO INC., Tokyo, Japan). Then we withdrew the FOB, and advanced the tube exchanger over the guide wire. Finally, we advanced a tracheal tube into the trachea over the tube exchanger. Because the tube exchanger is harder than the FOB, it is easier to advance a tracheal tube. This method also could avoid damaging the FOB. In this way, we didn't have to fit the size of the FOB to a tracheal tube. It is a rather more complicated way than the traditional one, which is intubating a tracheal tube directly following FOB, but it seems to be safer and more secure. Furthermore, this strategy can be applicable when intubating a double-lumen endobronchial tube. We recommended our method in FOB-guided intubation to prevent FOB damage.
