Effect of obesity on displacement of left-sided double-lumen tube during positional changes
10.3760/cma.j.cn131073.20240218.00707
- VernacularTitle:肥胖因素对患者体位改变时左侧双腔气管导管移位的影响
- Author:
Aimin FENG
1
;
Yingshuai QIAO
;
Zhen ZHANG
;
Xihua LU
Author Information
1. 郑州大学附属肿瘤医院(河南省肿瘤医院)麻醉与围术期医学科，郑州 450008
- Keywords:
Obesity;
Posture;
Intubation, intratracheal;
Double lumen tracheal
- From:
Chinese Journal of Anesthesiology
2024;44(7):802-805
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of obesity on the displacement of a left-sided double-lumen tube (DLT) during positional changes.Methods:This was a prospective cohort study. Six hundred and two patients who underwent elective chest surgery and required insertion of a left-sided DLT from February 2020 to November 2023 in our hospital were selected and divided into 2 groups based on the body mass index (BMI): obesity group (BMI≥28 kg/m 2,n=208) and non-obesity group (18.5 kg/m 2≤BMI<28 kg/m 2,n=394). General characteristics of patients, history of chest surgery, DLT model, depth of DLT placement in supine position, height/depth of placement (H/D) ratio, and distance of DLT displacement were recorded. DLT displacement was defined as a displacement distance of ≥15 mm. The logistic regression was used for analysis of the relationship between BMI and left DLT shift during positional changes. The receiver operating characteristic curve was used to evaluate the accuracy of BMI in predicting the left-sided DLT displacement during positional changes. Results:Compared with non-obese group, the depth of DLT placement was significantly reduced, the H/D ratio was increased, the distance of DLT displacement was increased, and the incidence of DLT displacement was increased in obese group ( P<0.05). The results of binary logistic regression analysis showed that a BMI≥28 kg/m 2 was an independent risk factor for DLT displacement ( OR value [95% confidence interval]=4.18 (2.36-7.38), P<0.001). The sensitivity of BMI in predicting the left-sided DLT displacement during positional changes was 77.4%, and the specificity was 69.6%, with an optimal cutoff value of 27.48 kg/m 2 and an area under the receiver operating characteristic curve of 0.757. Conclusions:Obesity can increase the probability of the left-sided DLT displacement during positional changes.
