Günal Hilal SAZAK, Uğur GÖKTAŞ, Çilsem SEVGEN, Özlem ERGİN, Eser ŞAVKILIOĞLU

Fiberoptik bronkoskop yardımıyla sağ ve sol endobronşiyal çift lümenli tüp kullanımının karşılaştırılması

Çalışmamızda sağ ve sol endobronşiyal çift lümenli tüp (ÇLT) kullanımını fiberoptik bronkoskop (FOB) yardımıyla karşılaştırmayı ve fiberoptik bronkoskopinin ÇLT kullanımına etkisini araştırmayı amaçladık. Elektif toraks cerrahisi yapılan ve tek akciğer ventilasyonu (TAV) gerektiren, ASA I-II, 30 erişkin olgu çalışmaya alındı. Yerleştirilen ÇLT, pozisyon açısından öncelikle klinik olarak değerlendirildi. Sonra supin, lateral dekübitus pozisyonda, ameliyat boyunca her 30 dk'da bir ve malpozisyon düşünüldüğünde FOB ile tüpün pozisyonu kontrol edilip, malpozisyon varsa düzeltildi. Her iki grupta kör entübasyon sonrası klinik değerlendirmeyle pozisyonu uygun bulunan ÇLT'lerin üçte birinde supin pozisyonda FOB ile malpozisyon saptandı. Olgunun lateral, dekiibitus pozisyona çevrilmesiyle sol ÇLT Grubunda 5 (no:15); sağ ÇLT Grubunda ise 7 (no: 15) olguda tüpün pozisyonunun bozulduğu gözlendi. Ameliyat sırasında sol ÇLT Grubunda 12, diğer grupta 8 olguda en az bir kez malpozisyon geliştiği görüldü. Klinik değerlendirmeyle tüp pozisyonunun uygun bulunması, ameliyat süresi ve toplam bronkoskopi sayısı sol ÇLT Grubunda daha fazlaydı (p

Comparison of right-sided and left-sided endobronchial double-lumen tube usage via fiberoptic bronchoscope

In this study we aimed to compare right-sided and left-sided endobronchial double-lumen tube (DLT) usage via fiberoptic bronchoscope (FOB). Moreover we also aimed to research the role of fiberoptic bronchoscopy on the administration of DLTs Thirty adult patients (ASAI-II) having elective thoracic surgery and requiring one-lung ventilation (OLV) were included in the study. First clinical assesment of the DLT position was made. Then the correct DLT position was confirmed by FOB in the supine, lateral decubitus positions, every 30 min during operation and whenever signs of malposition occurred and when malposition was identified it was corrected. In both groups after blind intubation malpositioning was detected by FOB with the ratio of 1:3 in the supine position in the tubes whose placement was judged correct by clinical assessment. After the patients were turned to the lateral decubitus position DLTs were found to be displaced in 5 of 15 and 7 of 15 patients in the left-sided and right-sided DLT groups respectively. In 12 patients in the left-sided DLT group and in 8 patients in the other group at least one malpositioning was detected during operation. The groups were similar in the time required for lung collapse and detection of malpositionings by FOB (p>0.05). The clinical verification of correct DLT placement, the mean length of operation and total numbers of bronchoscopies were higher in the left-sided DLT group (p

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