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About Importance Of Precise
Placement Of Double – Lumen Tube During Anesthesia And Surgery
A double-lumen tube (DLT) is an
endotracheal tube designed to isolate the lungs anatomically and
physiologically. Double-lumen tubes (DLTs) are the most
commonly used tubes to provide independent ventilation for each
lung.
One-lung ventilation (OLV) or lung
isolation is the mechanical and functional separation of the 2
lungs to allow selective ventilation of only one lung. The other
lung that is not being ventilated passively deflates or is
displaced by the surgeon to facilitate surgical exposure for
non-cardiac operations in the chest such as thoracic, esophageal,
aortic and spine procedures. It can also be used during minimally
invasive cardiac surgery and in disease processes.
DLT is an essential equipment for
thoracic anesthesia and its precise placement is particularly
important for anesthesia and surgery.
Incidence of DLT malposition remains
high and it leads to lung isolation failure and hypoxemia during
one-lung ventilation.
In one such incidence, the
Supreme Court directed Manipal Hospital to pay Rs 10 lakh
compensation to the widow of a patient who developed hoarseness in
his voice as a result of faulty insertion of a double lumen tube
while administering anaesthesia. While the operating surgeon
had assured the patient that the patient could regain his voice
within 6-8 months with nebulization and voice therapy, the
patient's voice was not restored and remained hoarse all through.
The patient had virtually lost his voice.
Doctors opined that there was
subluxation of the left arytenoid process, which happened due to
wrong intubation during the anaesthesia procedure. It was found to
be on account of the trauma caused leading to the paralysis of the
vocal cord.
https://medicaldialogues.in/pdf_upload/supreme-court-rs-10-lakhcompensation-232650.pdf
https://www.ncbi.nlm.nih.gov/books/NBK535366/
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