Lung Isolation — Devices, Sizing & Position
Methods of lung isolation
Gold standardDouble-lumen tube (DLT)
Bronchial blocker (BB)
Single-lumen tube (SLT) → endobronchial
| DLT sizing (by height) | Female | Male |
|---|---|---|
| < 160 cm | 35 Fr | 39 Fr |
| > 160 cm | 37 Fr | 41 Fr |
📏 DLT depth & confirmation
- Depth of DLT (cm) ≈ height (cm)/10 + 12.
- A left-sided DLT is usually preferred (longer bronchial margin of safety); confirm placement clinically and with fibreoptic bronchoscopy (FOB) — and re-check after turning the patient to the lateral position (tubes migrate).
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Positioning — lateral decubitus
- Turn to the lateral position; re-check DLT position with FOB after the turn.
- Avoid pressure-related complications — eyes, pinna, cervical spine, hyperabduction of the arm (brachial plexus), pressure areas, the down-side neurovascular bundle.