Objective: To compare performance of right- versus leftsided
double-lumen tubes (DLTs) among infrequent users by
evaluating the incidence and severity of hypoxemia, hypercapnia,
and high airway pressures.
Design: A retrospective, cohort study.
Setting: A university hospital.
Participants: Ninety-eight patients undergoing left-sided
DLT placement (53.9  21.2 years old) and 98 patients
undergoing right-sided DLT placement (62.3  20.6 years
old). Cases performed by thoracic anesthesia specialists
were excluded.
Interventions: The authors retrospectively reviewed electronic
anesthetic records from a 2-year period to determine
the incidence and severity of hypoxia (SpO2 < 90%), hypercapnia (end-tidal carbon dioxide > 45 mmHg) and high airway
pressures (peak inspiratory pressure >35 cmH2O) during
one-lung ventilation via right and left DLTs.
Measurements and Main Results: Right-sided (n  98)
DLTs were almost exclusively used on the side contralateral
to surgery by infrequent users, whereas left-sided
(n  98) DLTs were used for ipsilateral surgery one third of
the time. Hypoxia lasted longer in left versus right DLTs,
but the frequency of hypoxia was the same for each tube
type among infrequent users. Hypercapnia and high airway
pressures occurred more frequently with left-sided
Conclusions: Left-sided DLTs are perceived to be safer
because they may be less prone to malpositioning during
lung isolation. However, the supposition that left-sided
DLTs are safer than right-sided DLTs when intraoperative
hypoxia, hypercapnia, and high airway pressures are used as
criteria, even when these tubes are used by infrequent users,
is not supported by the data.