Determination of the True Inclination Angle of the Main Bronchi Relative to the Median Sagittal Plane for Placement of a Left-Sided Double-Lumen Tube
Objectives This study aimed to determine the true inclination angle of the main bronchi relative to the median sagittal plane, using CT imaging to help increase accuracy of double-lumen tube (DLT) placement. Design In this retrospective study, 2 investigators independently measured normal chest CT s...
Gespeichert in:
| Veröffentlicht in: | Journal of cardiothoracic and vascular anesthesia 2017-04, Vol.31 (2), p.434-440 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 440 |
|---|---|
| container_issue | 2 |
| container_start_page | 434 |
| container_title | Journal of cardiothoracic and vascular anesthesia |
| container_volume | 31 |
| creator | Patel, Rajesh V., MD, MSEd Van Noord, Brandon A., MD Patel, Dakshesh, MD Hong, Elizabeth J., MD Bourne, Eric, MD Patel, Reema R., BA Chandrasoma, Janak, MD Chan, Linda, PhD Szenohradszki, Janos, MD, PhD Lumb, Philip D., MBBS, MCCM |
| description | Objectives This study aimed to determine the true inclination angle of the main bronchi relative to the median sagittal plane, using CT imaging to help increase accuracy of double-lumen tube (DLT) placement. Design In this retrospective study, 2 investigators independently measured normal chest CT scans from 50 male and 50 female patients. To determine the true AP axis, a mid-sagittal plane reference line (MSPRL) was drawn, intersecting the midsternum and the vertebral spinous process at the level of mid-carina. Lines were drawn through the center of each main bronchus to determine the inclination angle with regard to the MSPRL. Setting Research was conducted at a single institution, the Los Angeles County and University of Southern California Medical Center. Participants Normal chest CT images from 50 women and 50 men. Main Results The mean true inclination angle between the main bronchi and trachea in the mid-sagittal plane was 108.4° on the left compared with 96.2° on the right (p |
| doi_str_mv | 10.1053/j.jvca.2016.06.022 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1859722457</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1053077016302245</els_id><sourcerecordid>1859722457</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-7385b015423be3b36bf63dc20d3c87f82a3c74f197a7b81915832a66fae71b5a3</originalsourceid><addsrcrecordid>eNp9Ul1rFDEUHUSxtfoHfJA8-jJrPiaTWRChtrYWVhR3fQ6ZzE2bcSapSWahP8T_a8J2ffBBuJBL7jmH3HNSVa8JXhHM2btxNe61WlFM2hXORemT6pRwRuuuofRp7jOqxkLgk-pFjCPGhHAunlcnVLQYrxk-rX5fQoIwW6eS9Q55g9IdoF1YAN04PR3vz93tBMfpF2Ud-hi803cWfYcpQ_aAkj8MYbDKoa26tSmpCX2blANkfCidhhlcKjoKbcCkemsHGNClX_oJ6s2Sp2i39PCyembUFOHV43lW_bj6tLv4XG--Xt9cnG9q3RCSasE63mPCG8p6YD1re9OyQVM8MN0J01HFtGgMWQsl-o6sCe8YVW1rFAjSc8XOqrcH3fvgfy0Qk5xt1DCVN_slStLxtaC04SJD6QGqg48xgJH3wc4qPEiCZTFajrLEIUscEueiNJPePOov_QzDX8rR_wx4fwBA3nJvIcioLTidTQygkxy8_b_-h3_oJTKr1fQTHiCOfgku-yeJjFRiuS065T-QluGyFvsDkRywPA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1859722457</pqid></control><display><type>article</type><title>Determination of the True Inclination Angle of the Main Bronchi Relative to the Median Sagittal Plane for Placement of a Left-Sided Double-Lumen Tube</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Patel, Rajesh V., MD, MSEd ; Van Noord, Brandon A., MD ; Patel, Dakshesh, MD ; Hong, Elizabeth J., MD ; Bourne, Eric, MD ; Patel, Reema R., BA ; Chandrasoma, Janak, MD ; Chan, Linda, PhD ; Szenohradszki, Janos, MD, PhD ; Lumb, Philip D., MBBS, MCCM</creator><creatorcontrib>Patel, Rajesh V., MD, MSEd ; Van Noord, Brandon A., MD ; Patel, Dakshesh, MD ; Hong, Elizabeth J., MD ; Bourne, Eric, MD ; Patel, Reema R., BA ; Chandrasoma, Janak, MD ; Chan, Linda, PhD ; Szenohradszki, Janos, MD, PhD ; Lumb, Philip D., MBBS, MCCM</creatorcontrib><description>Objectives This study aimed to determine the true inclination angle of the main bronchi relative to the median sagittal plane, using CT imaging to help increase accuracy of double-lumen tube (DLT) placement. Design In this retrospective study, 2 investigators independently measured normal chest CT scans from 50 male and 50 female patients. To determine the true AP axis, a mid-sagittal plane reference line (MSPRL) was drawn, intersecting the midsternum and the vertebral spinous process at the level of mid-carina. Lines were drawn through the center of each main bronchus to determine the inclination angle with regard to the MSPRL. Setting Research was conducted at a single institution, the Los Angeles County and University of Southern California Medical Center. Participants Normal chest CT images from 50 women and 50 men. Main Results The mean true inclination angle between the main bronchi and trachea in the mid-sagittal plane was 108.4° on the left compared with 96.2° on the right (p<0.0001). Interventions No specific interventions were done because this was a retrospective study and CT scan analysis. Conclusion The data suggested that the trachea does not merely branch in the horizontal plane but branches posteriorly as well, with a true mean anatomic angle between the left main bronchus and trachea of 108.4°. This finding concurred with the authors’ suggestion that the DLT be rotated to 110° counterclockwise instead of the routine practice of 90°. The authors suggest clinicians rotate the DLT an additional 20° counterclockwise and direct the top of the DLT to the 11 o’clock position.</description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2016.06.022</identifier><identifier>PMID: 27600930</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; anesthesia ; Anesthesia & Perioperative Care ; angle ; bifurcation ; Bronchi - anatomy & histology ; Bronchi - diagnostic imaging ; bronchial ; Bronchoscopy - methods ; bronchus ; carina ; counterclockwise ; Critical Care ; divide ; double-lumen tube ; endobronchial ; Female ; fiberoptic ; head turn ; Humans ; Imaging, Three-Dimensional - methods ; intubation ; Intubation, Intratracheal - methods ; left-sided ; lumen ; lung ; Male ; Middle Aged ; posterior ; Retrospective Studies ; rotate ; rotation ; success rate ; thoracic ; Tomography, X-Ray Computed - methods ; tracheal ; vocal cords</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2017-04, Vol.31 (2), p.434-440</ispartof><rights>2017</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-7385b015423be3b36bf63dc20d3c87f82a3c74f197a7b81915832a66fae71b5a3</citedby><cites>FETCH-LOGICAL-c411t-7385b015423be3b36bf63dc20d3c87f82a3c74f197a7b81915832a66fae71b5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.jvca.2016.06.022$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27600930$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patel, Rajesh V., MD, MSEd</creatorcontrib><creatorcontrib>Van Noord, Brandon A., MD</creatorcontrib><creatorcontrib>Patel, Dakshesh, MD</creatorcontrib><creatorcontrib>Hong, Elizabeth J., MD</creatorcontrib><creatorcontrib>Bourne, Eric, MD</creatorcontrib><creatorcontrib>Patel, Reema R., BA</creatorcontrib><creatorcontrib>Chandrasoma, Janak, MD</creatorcontrib><creatorcontrib>Chan, Linda, PhD</creatorcontrib><creatorcontrib>Szenohradszki, Janos, MD, PhD</creatorcontrib><creatorcontrib>Lumb, Philip D., MBBS, MCCM</creatorcontrib><title>Determination of the True Inclination Angle of the Main Bronchi Relative to the Median Sagittal Plane for Placement of a Left-Sided Double-Lumen Tube</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description>Objectives This study aimed to determine the true inclination angle of the main bronchi relative to the median sagittal plane, using CT imaging to help increase accuracy of double-lumen tube (DLT) placement. Design In this retrospective study, 2 investigators independently measured normal chest CT scans from 50 male and 50 female patients. To determine the true AP axis, a mid-sagittal plane reference line (MSPRL) was drawn, intersecting the midsternum and the vertebral spinous process at the level of mid-carina. Lines were drawn through the center of each main bronchus to determine the inclination angle with regard to the MSPRL. Setting Research was conducted at a single institution, the Los Angeles County and University of Southern California Medical Center. Participants Normal chest CT images from 50 women and 50 men. Main Results The mean true inclination angle between the main bronchi and trachea in the mid-sagittal plane was 108.4° on the left compared with 96.2° on the right (p<0.0001). Interventions No specific interventions were done because this was a retrospective study and CT scan analysis. Conclusion The data suggested that the trachea does not merely branch in the horizontal plane but branches posteriorly as well, with a true mean anatomic angle between the left main bronchus and trachea of 108.4°. This finding concurred with the authors’ suggestion that the DLT be rotated to 110° counterclockwise instead of the routine practice of 90°. The authors suggest clinicians rotate the DLT an additional 20° counterclockwise and direct the top of the DLT to the 11 o’clock position.</description><subject>Adult</subject><subject>Aged</subject><subject>anesthesia</subject><subject>Anesthesia & Perioperative Care</subject><subject>angle</subject><subject>bifurcation</subject><subject>Bronchi - anatomy & histology</subject><subject>Bronchi - diagnostic imaging</subject><subject>bronchial</subject><subject>Bronchoscopy - methods</subject><subject>bronchus</subject><subject>carina</subject><subject>counterclockwise</subject><subject>Critical Care</subject><subject>divide</subject><subject>double-lumen tube</subject><subject>endobronchial</subject><subject>Female</subject><subject>fiberoptic</subject><subject>head turn</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional - methods</subject><subject>intubation</subject><subject>Intubation, Intratracheal - methods</subject><subject>left-sided</subject><subject>lumen</subject><subject>lung</subject><subject>Male</subject><subject>Middle Aged</subject><subject>posterior</subject><subject>Retrospective Studies</subject><subject>rotate</subject><subject>rotation</subject><subject>success rate</subject><subject>thoracic</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>tracheal</subject><subject>vocal cords</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Ul1rFDEUHUSxtfoHfJA8-jJrPiaTWRChtrYWVhR3fQ6ZzE2bcSapSWahP8T_a8J2ffBBuJBL7jmH3HNSVa8JXhHM2btxNe61WlFM2hXORemT6pRwRuuuofRp7jOqxkLgk-pFjCPGhHAunlcnVLQYrxk-rX5fQoIwW6eS9Q55g9IdoF1YAN04PR3vz93tBMfpF2Ud-hi803cWfYcpQ_aAkj8MYbDKoa26tSmpCX2blANkfCidhhlcKjoKbcCkemsHGNClX_oJ6s2Sp2i39PCyembUFOHV43lW_bj6tLv4XG--Xt9cnG9q3RCSasE63mPCG8p6YD1re9OyQVM8MN0J01HFtGgMWQsl-o6sCe8YVW1rFAjSc8XOqrcH3fvgfy0Qk5xt1DCVN_slStLxtaC04SJD6QGqg48xgJH3wc4qPEiCZTFajrLEIUscEueiNJPePOov_QzDX8rR_wx4fwBA3nJvIcioLTidTQygkxy8_b_-h3_oJTKr1fQTHiCOfgku-yeJjFRiuS065T-QluGyFvsDkRywPA</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Patel, Rajesh V., MD, MSEd</creator><creator>Van Noord, Brandon A., MD</creator><creator>Patel, Dakshesh, MD</creator><creator>Hong, Elizabeth J., MD</creator><creator>Bourne, Eric, MD</creator><creator>Patel, Reema R., BA</creator><creator>Chandrasoma, Janak, MD</creator><creator>Chan, Linda, PhD</creator><creator>Szenohradszki, Janos, MD, PhD</creator><creator>Lumb, Philip D., MBBS, MCCM</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170401</creationdate><title>Determination of the True Inclination Angle of the Main Bronchi Relative to the Median Sagittal Plane for Placement of a Left-Sided Double-Lumen Tube</title><author>Patel, Rajesh V., MD, MSEd ; Van Noord, Brandon A., MD ; Patel, Dakshesh, MD ; Hong, Elizabeth J., MD ; Bourne, Eric, MD ; Patel, Reema R., BA ; Chandrasoma, Janak, MD ; Chan, Linda, PhD ; Szenohradszki, Janos, MD, PhD ; Lumb, Philip D., MBBS, MCCM</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-7385b015423be3b36bf63dc20d3c87f82a3c74f197a7b81915832a66fae71b5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>anesthesia</topic><topic>Anesthesia & Perioperative Care</topic><topic>angle</topic><topic>bifurcation</topic><topic>Bronchi - anatomy & histology</topic><topic>Bronchi - diagnostic imaging</topic><topic>bronchial</topic><topic>Bronchoscopy - methods</topic><topic>bronchus</topic><topic>carina</topic><topic>counterclockwise</topic><topic>Critical Care</topic><topic>divide</topic><topic>double-lumen tube</topic><topic>endobronchial</topic><topic>Female</topic><topic>fiberoptic</topic><topic>head turn</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional - methods</topic><topic>intubation</topic><topic>Intubation, Intratracheal - methods</topic><topic>left-sided</topic><topic>lumen</topic><topic>lung</topic><topic>Male</topic><topic>Middle Aged</topic><topic>posterior</topic><topic>Retrospective Studies</topic><topic>rotate</topic><topic>rotation</topic><topic>success rate</topic><topic>thoracic</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>tracheal</topic><topic>vocal cords</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patel, Rajesh V., MD, MSEd</creatorcontrib><creatorcontrib>Van Noord, Brandon A., MD</creatorcontrib><creatorcontrib>Patel, Dakshesh, MD</creatorcontrib><creatorcontrib>Hong, Elizabeth J., MD</creatorcontrib><creatorcontrib>Bourne, Eric, MD</creatorcontrib><creatorcontrib>Patel, Reema R., BA</creatorcontrib><creatorcontrib>Chandrasoma, Janak, MD</creatorcontrib><creatorcontrib>Chan, Linda, PhD</creatorcontrib><creatorcontrib>Szenohradszki, Janos, MD, PhD</creatorcontrib><creatorcontrib>Lumb, Philip D., MBBS, MCCM</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patel, Rajesh V., MD, MSEd</au><au>Van Noord, Brandon A., MD</au><au>Patel, Dakshesh, MD</au><au>Hong, Elizabeth J., MD</au><au>Bourne, Eric, MD</au><au>Patel, Reema R., BA</au><au>Chandrasoma, Janak, MD</au><au>Chan, Linda, PhD</au><au>Szenohradszki, Janos, MD, PhD</au><au>Lumb, Philip D., MBBS, MCCM</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Determination of the True Inclination Angle of the Main Bronchi Relative to the Median Sagittal Plane for Placement of a Left-Sided Double-Lumen Tube</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>31</volume><issue>2</issue><spage>434</spage><epage>440</epage><pages>434-440</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract>Objectives This study aimed to determine the true inclination angle of the main bronchi relative to the median sagittal plane, using CT imaging to help increase accuracy of double-lumen tube (DLT) placement. Design In this retrospective study, 2 investigators independently measured normal chest CT scans from 50 male and 50 female patients. To determine the true AP axis, a mid-sagittal plane reference line (MSPRL) was drawn, intersecting the midsternum and the vertebral spinous process at the level of mid-carina. Lines were drawn through the center of each main bronchus to determine the inclination angle with regard to the MSPRL. Setting Research was conducted at a single institution, the Los Angeles County and University of Southern California Medical Center. Participants Normal chest CT images from 50 women and 50 men. Main Results The mean true inclination angle between the main bronchi and trachea in the mid-sagittal plane was 108.4° on the left compared with 96.2° on the right (p<0.0001). Interventions No specific interventions were done because this was a retrospective study and CT scan analysis. Conclusion The data suggested that the trachea does not merely branch in the horizontal plane but branches posteriorly as well, with a true mean anatomic angle between the left main bronchus and trachea of 108.4°. This finding concurred with the authors’ suggestion that the DLT be rotated to 110° counterclockwise instead of the routine practice of 90°. The authors suggest clinicians rotate the DLT an additional 20° counterclockwise and direct the top of the DLT to the 11 o’clock position.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27600930</pmid><doi>10.1053/j.jvca.2016.06.022</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1053-0770 |
| ispartof | Journal of cardiothoracic and vascular anesthesia, 2017-04, Vol.31 (2), p.434-440 |
| issn | 1053-0770 1532-8422 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1859722457 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aged anesthesia Anesthesia & Perioperative Care angle bifurcation Bronchi - anatomy & histology Bronchi - diagnostic imaging bronchial Bronchoscopy - methods bronchus carina counterclockwise Critical Care divide double-lumen tube endobronchial Female fiberoptic head turn Humans Imaging, Three-Dimensional - methods intubation Intubation, Intratracheal - methods left-sided lumen lung Male Middle Aged posterior Retrospective Studies rotate rotation success rate thoracic Tomography, X-Ray Computed - methods tracheal vocal cords |
| title | Determination of the True Inclination Angle of the Main Bronchi Relative to the Median Sagittal Plane for Placement of a Left-Sided Double-Lumen Tube |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T15%3A00%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Determination%20of%20the%20True%20Inclination%20Angle%20of%20the%20Main%20Bronchi%20Relative%20to%20the%20Median%20Sagittal%20Plane%20for%20Placement%20of%20a%20Left-Sided%20Double-Lumen%20Tube&rft.jtitle=Journal%20of%20cardiothoracic%20and%20vascular%20anesthesia&rft.au=Patel,%20Rajesh%20V.,%20MD,%20MSEd&rft.date=2017-04-01&rft.volume=31&rft.issue=2&rft.spage=434&rft.epage=440&rft.pages=434-440&rft.issn=1053-0770&rft.eissn=1532-8422&rft_id=info:doi/10.1053/j.jvca.2016.06.022&rft_dat=%3Cproquest_cross%3E1859722457%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1859722457&rft_id=info:pmid/27600930&rft_els_id=S1053077016302245&rfr_iscdi=true |