A clinical comparison of bronchial cuff pressures in three different designs of left double-lumen tubes

This study compared the bronchial cuff pressures and volumes required by three different designs of disposable left double-lumen tubes during clinical one-lung ventilation in 48 patients having right thoracotomies. Mallinckrodt, Rusch, and Sheridan design tubes (n = 16 for each) were studied in a randomized fashion using Fr# 35, 37, 39, and 41 sizes (n = 12 for each size). There were no pressure/volume differences between brands during bronchial cuff inflation before endotracheal intubation. Intraoperatively, the Sheridan design required significantly higher mean bronchial cuff pressures: [27.9 cm H2O +/- 17 cm H2O (SD)] than either the Mallinckrodt [17.6 cm H2O +/- 8.5 cm H2O (P = 0.012)] or Rusch [14.1 cm H2O +/- 8.6 cm H2O (P = 0.010)] to achieve one-lung isolation. During prolonged one-lung ventilation, the potential for trauma to the bronchus may be reduced with a Mallinckrodt or Rusch design of left double-lumen tube.