Placement of a double lumen tube for lung surgery is best confirmed by -

Ans. is 'd' i.e., Bronchoscopy * During thoracic surgery, there is a need for one lung to be deflated and or isolated.This offers the surgeon easier and better access within the designated hemothorax.In order to achieve these double-lumen endobronchial tubes are used that allow the anesthetist to selectively deflate one lung while maintaining standard ventilation of the other.Components of the Double lumen tubeDouble lumen endobronchial tube has two separate color-coded lumens each with its own level.One lumen ends in the trachea and the other lumen ends in either the left or right main bronchus.Each lumen has its own cuff (tracheal a bronchial cuffs) and color-coded pilot balloons.The proximal end of these tubes is connected to a breathing system.Mechanism of actionBecause of the differing anatomy of the main bronchi and their branches, both right and left versions of any particular double lumen tube must exist.Once correctly positioned the anesthetist can selectively ventilate one lung, so for operations requiring that the right lung is deflated, a left-sided double lumen tube would be used that enables selective ventilation of the left lung alone and vice versa.How to confirm the position of the double Lumen tube?The position of the tubes should be checked by auscultation immediately after intubation and after positioning the patient for operation.The auscultatory method for checking the correct placement of tube is lust a clinical method for ensuring correct placement of the tube and the confirmation of correct placement of the tube should be the done by flexible fiberoptic bronchoscopy.What is the use of end-tidal CO2 determination (EtCO2) in intubation?.The EtC02 can be used to confirm the position of the endotracheal tube. (whether the tube is in esophagus or trachea)The persistent detection of CO2 by a capnograph is the best confirmation of tracheal placement of an endotracheal tube (EtCO2).Note: Capnography can detect whether the tube is in trachea or esophagus but cannot differentiate between tracheal intubation and endobronchial intubation because in both these cases there will be the persistent detection of CO2.Double lumen tube