A blind guided technique for placing double-lumen endobronchial tubes

A new technique is described to aid in achieving a correct blind insertion of an endobronchial tube. The tube is selected by length to fit the distance from the patient's mouth to carina. As the tube is inserted, the position of the endobronchial cuff is monitored. This is done by inflating the bronchial cuff in the trachea and after each breath, advancing the tube down the trachea until only one lung is inflated. This accurately identifies the bronchial cuff as just beyond the carina, at the entrance to the main bronchus. From here, the tube can be advanced precisely into the bronchus to give the optimal conditions for isolation of the right and left lungs.