The double-lumen endotracheal tube (DLT) was introduced by Carlens in 1949 and became widely used for single-lung ventilation. DLTs have since become standard for most pulmonary resections. Although the use of DLTs is routine and safe in experienced hands, it is not without risk. Airway injury is an uncommon but potentially fatal complication. Complications of DLT placement are infrequently reported. The incidence of postintubation tracheobronchial rupture is estimated to be 1 in 20,000 to 1 in 75,000 among all intubations (single-lumen endotracheal tubes and DLTs). The estimated incidence after DLT insertions is significantly higher than that of single-lumen endotracheal tube injury, with DLT airway injury incidence ranging from 0.05% to 0.19%.
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