For a right thoracotomy requiring one-lung ventilation, what size double-lumen tube (DLT) is preferred?

In the context of one-lung ventilation during a right thoracotomy, the preferred size for a double-lumen tube (DLT) is influenced by several factors, including the patient's anatomy and the specific aims of the procedure. A 39 French DLT is commonly chosen for adults, as it strikes a balance between providing sufficient airflow, facilitating the separation of lung ventilation, and ensuring that the tube provides effective bronchial occlusion.

The 39 French DLT is appropriately sized to fit the typical adult bronchial dimensions, allowing for adequate lung isolation while minimizing obstructive risks or complications. This size helps in achieving effective ventilation of the non-operative lung while deflating the operative lung, which is crucial in thoracic surgeries to ensure optimal surgical conditions.

Larger DLTs, such as the 41 or 43 French sizes, may not always be necessary and could lead to complications or increased trauma to the bronchial tissue. Conversely, smaller DLTs, like the 37 French, may not provide sufficient ventilation or isolation for certain thoracic surgeries, leading to suboptimal surgical conditions. Therefore, the 39 French DLT is favored as it effectively meets the requirements of one-lung ventilation while ensuring patient safety and comfort.