Other Tubes- RAE, Endotrol, Double lumen tube

Apart from the traditional tubes used for endotracheal intubation, other tubes like R.A.E tube, Endotrol tube and Double lumen tube.

R.A.E. tube :

The R.A.E. tube is named after the name of 3 scientists — Ring, Adair and Elwyn.

R.A.E tube is of two types:

• South facing: Used for upper cleft lip and cleft palate surgery.

• North facing: Used for lower lip surgery. Spiral embedded (also called armored tube): These are non kink able, non collapsible so used for head and neck surgeries where acute flexion of neck is required.

Microlaryngeal and laryngotracheal surgery tube

(MLT, LTS tubes): Used for microlaryngeal surgeries.

Coles tube: Used for children, the distal end of tube has narrow diameter (because in children narrowest part is subglottis).

Endotrol tube: Angle of tip can be changed, so excellent for nasal intubation.

Double lumen tube : Robertshaw’s and Carlens tubes are used for thoracic surgery where one lung ventilation is required.

Indication for one lung ventilation lung separation and the use of Double lumen tube like Robertshaw’s and Carlens tubes are:

Absolute indications of Double lumen tube

(1) To prevent spillage of contents of one lung (like pus, blood) to other side

(2) Unilateral bronchopleural lavage,

(3) Massive bronchopleural bronchocutaneous fistula,

(4) Large lung cystibulla the rupture of which may cause tension pneumothorax.

Relative Indications of Double lumen tube :

Any surgery on the other mediastinal contents like thoracic aorta or esophagus is considered as relative indication.

Complications of Double lumen tube :

i. Hypoxia: The most common cause of hypoxia is Malposition of tube (in wrong bronchus) therefore position of Double lumen tube must be verified by Bronchoscopy (which can only tell whether the tube is in right or left bronchus or still in trachea), other cause of hypoxia is V/Q mismatch.

ii. Trauma to larynx.

iii. Brochial rupture: Due to over inflation of cuff in bronchus.

Combitube:

It is special type of double lumen tube used for providing patent airway in emergency and difficult intubation

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