Cargando…

"Detachment of the carinal hook following endobronchial intubation with a double lumen tube"

BACKGROUND: Carinal hooks increases difficulty at endotracheal intubation. Amputation of the carinal hook during passage and malpositioning of the tube to the hook are some of the potential problems related with left-sided Carlens double lumen tube (DLT). This article reports an amputation of the ho...

Descripción completa

Detalles Bibliográficos
Autores principales: Rocha, Ana C, Martins, Mafalda G, Silva, Luísa I, Nunes, José M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229443/
https://www.ncbi.nlm.nih.gov/pubmed/22035156
http://dx.doi.org/10.1186/1471-2253-11-20
_version_ 1782217937093918720
author Rocha, Ana C
Martins, Mafalda G
Silva, Luísa I
Nunes, José M
author_facet Rocha, Ana C
Martins, Mafalda G
Silva, Luísa I
Nunes, José M
author_sort Rocha, Ana C
collection PubMed
description BACKGROUND: Carinal hooks increases difficulty at endotracheal intubation. Amputation of the carinal hook during passage and malpositioning of the tube to the hook are some of the potential problems related with left-sided Carlens double lumen tube (DLT). This article reports an amputation of the hook during a difficult selective intubation and aimed at calling the attention to complications associated with DLTs and the importance of fiberoptic bronchoscopy. CASE PRESENTATION: A 68 year-old woman was scheduled for right-sided thoracotomy in whom blind DLT insertion was performed. Narrowed trachea causes difficulty in rotating the DLT 90° counter-clockwise. After carinal hook was noticed upon visual inspection of the DLT, fiberoptic bronchoscopy was used to remove the missing part (with the use of forceps) from the right mainstem bronchus. CONCLUSION: Insertion of DLTs with carinal hook is associated with technical problems and potentially life-threatening hazards have discouraged their use. Fiberoptic evaluation and repositioning solves most of the problems. Although amputation of the carinal hook has not been previously reported, clinicians should be alert. This case report emphasizes the utility of the fiberoptic bronchoscopy in the operating theatre for placement, positioning and inspection of the carinal hook DLT.
format Online
Article
Text
id pubmed-3229443
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-32294432011-12-03 "Detachment of the carinal hook following endobronchial intubation with a double lumen tube" Rocha, Ana C Martins, Mafalda G Silva, Luísa I Nunes, José M BMC Anesthesiol Case Report BACKGROUND: Carinal hooks increases difficulty at endotracheal intubation. Amputation of the carinal hook during passage and malpositioning of the tube to the hook are some of the potential problems related with left-sided Carlens double lumen tube (DLT). This article reports an amputation of the hook during a difficult selective intubation and aimed at calling the attention to complications associated with DLTs and the importance of fiberoptic bronchoscopy. CASE PRESENTATION: A 68 year-old woman was scheduled for right-sided thoracotomy in whom blind DLT insertion was performed. Narrowed trachea causes difficulty in rotating the DLT 90° counter-clockwise. After carinal hook was noticed upon visual inspection of the DLT, fiberoptic bronchoscopy was used to remove the missing part (with the use of forceps) from the right mainstem bronchus. CONCLUSION: Insertion of DLTs with carinal hook is associated with technical problems and potentially life-threatening hazards have discouraged their use. Fiberoptic evaluation and repositioning solves most of the problems. Although amputation of the carinal hook has not been previously reported, clinicians should be alert. This case report emphasizes the utility of the fiberoptic bronchoscopy in the operating theatre for placement, positioning and inspection of the carinal hook DLT. BioMed Central 2011-10-28 /pmc/articles/PMC3229443/ /pubmed/22035156 http://dx.doi.org/10.1186/1471-2253-11-20 Text en Copyright ©2011 Rocha et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Rocha, Ana C
Martins, Mafalda G
Silva, Luísa I
Nunes, José M
"Detachment of the carinal hook following endobronchial intubation with a double lumen tube"
title "Detachment of the carinal hook following endobronchial intubation with a double lumen tube"
title_full "Detachment of the carinal hook following endobronchial intubation with a double lumen tube"
title_fullStr "Detachment of the carinal hook following endobronchial intubation with a double lumen tube"
title_full_unstemmed "Detachment of the carinal hook following endobronchial intubation with a double lumen tube"
title_short "Detachment of the carinal hook following endobronchial intubation with a double lumen tube"
title_sort "detachment of the carinal hook following endobronchial intubation with a double lumen tube"
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229443/
https://www.ncbi.nlm.nih.gov/pubmed/22035156
http://dx.doi.org/10.1186/1471-2253-11-20
work_keys_str_mv AT rochaanac detachmentofthecarinalhookfollowingendobronchialintubationwithadoublelumentube
AT martinsmafaldag detachmentofthecarinalhookfollowingendobronchialintubationwithadoublelumentube
AT silvaluisai detachmentofthecarinalhookfollowingendobronchialintubationwithadoublelumentube
AT nunesjosem detachmentofthecarinalhookfollowingendobronchialintubationwithadoublelumentube