Free
Correspondence  |   July 2003
Endobronchial Blocker Response
Author Notes
  • University of Wisconsin Medical School, Madison, Wisconsin.
Article Information
Correspondence
Correspondence   |   July 2003
Endobronchial Blocker Response
Anesthesiology 7 2003, Vol.99, 240. doi:
Anesthesiology 7 2003, Vol.99, 240. doi:
To the Editor:—
I would like to respond to Dr. Campos’ excellent article on options for one-lung ventilation. 1 The use of a conventional single-lumen endotracheal tube is more efficient in providing ventilation relative to a double-lumen tube, or Univent® endotracheal tube (Vitaid, Lewiston, NY). This difference is even greater during one-lung ventilation with a double-lumen endotracheal tube. The cross-sectional area will decrease by an additional 50%. The 8.0 and 8.5 single-lumen endotracheal tubes are the most common sizes of wire-guided endobronchial blocker (WEB®; Cook, Bloomington, IN) systems placed. The equivalent outer diameter double-lumen and Univent® tube would be 32 French, 35 French, 6.0-mm internal diameter, and 7.0-mm internal diameter, respectively. As compared to a single lumen-endotracheal tube, the inner diameter is small relative to the outer diameter. When comparing the 32 French and 35 French double-lumen tubes, they have a combined internal diameter of 5.0 to 6.0 mm, respectively. The internal diameter for ventilation decreases to 3.4 to 3.5 mm and 4.3 to 4.5 mm, respectively. The equivalent diameter Univent® tubes have an internal diameter of 6.0 to 7.0 mm. The WEB® allows patient management with a large internal diameter endotracheal tube as compared to the Univent® endotracheal tube or double-lumen endotracheal tube with the same approximate outer diameter. The WEB® is now made in a 7 French adult diameter, which makes placement through 7.0 or 7.5 endotracheal tubes relatively easy.
The advantages of the WEB® are several; however, the ability to conserve internal diameter as compared to outer diameter is an important advantage. Both the Univent® and double-lumen endotracheal tube lose a large part of their internal diameter because of the extra plastic material used, which is inherent in their construction.
Reference
Reference
Campos JH: Current techniques for perioperative lung isolation in adults. A nesthesiology 2002; 97: 1295–301Campos, JH