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Should a fibreoptic bronchoscope be used to confirm double lumen tube placement?

The authors commonly use PVC BronchoCath double lumen tubes (DLTs) (Mallinckrodt Medical Inc., St. Louis, MO, USA). The DLT is introduced through the vocal cords after appropriate sizing, the stylet removed, the DLT rotated anti-clockwise and advanced down the airway. The airway is secured by inflating the tracheal cuff. The patient is ventilated with a volume of 8 ml/kg, the chest auscultated and peak airway pressure recorded. To isolate a lung the bronchial cuff is inflated with <3 ml of air until there is no audible leak. The connector on the redundant side is clamped, the limb is opened to air and ventilation occurs via the appropriate lumen.