TY - JOUR
T1 - A Randomized Controlled Study of the Use of Video Double-Lumen Endobronchial Tubes Versus Double-Lumen Endobronchial Tubes in Thoracic Surgery
AU - Singh Heir, Jagtar
AU - Guo, Shu Lin
AU - Purugganan, Ronaldo V
AU - Jackson, Timothy Albert
AU - Sekhon, Anupamjeet Kaur
AU - Mirza, Kazim
AU - Lasala, Javier
AU - Feng, Lei
AU - Cata, Juan P
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/2
Y1 - 2018/2
N2 - Objective: To compare the incidence of fiberoptic bronchoscope (FOB) use (1) during verification of initial placement and (2) for reconfirmation of correct placement following repositioning, when either a double-lumen tube (DLT) or video double-lumen tube (VDLT) was used for lung isolation during thoracic surgery. Design: A randomized controlled study. Setting: Single-center university teaching hospital. Participants: The study comprised 80 patients who were 18 years or older requiring lung isolation for surgery. Interventions: After institutional review board approval, patients were randomized prior to surgery to either DLT or VDLT usage. Attending anesthesiologists placed the Mallinckrodt DLT or Vivasight (ET View Ltd, Misgav, Israel) VDLT with conventional laryngoscopy or video laryngoscopy then verified correct tube position through the view provided with either VDLT external monitor or FOB. Measurements and Main Results: Data collected included: sex, body mass index, successful intubation and endobronchial placement, intubation time, confirmation time of tube position, FOB use, quality of view, dislodgement of tube, and ability to forewarn dislodgement of endobronchial cuff and complications. FOB use for verification of final position of the tube (VDLT 13.2% [5/38] v DLT 100% [42/42], p < 0.0001), need for FOB to correct the dislodgement (VDLT 7.7% [1/13] v DLT 100% [14/14], p < 0.0001), dislodgement during positioning (VDLT 61.5% [8/13] v DLT 64.3% [9/14], p = ns), dislodgement during surgery (VDLT 38.5% [5/13] v DLT 21.4% [3/14], p = ns), and ability to forewarn dislodgement of endobronchial cuff (VDLT 18.4% [7/38] v DLT 4.8% [2/42], p = 0.078). Conclusion: This study demonstrated a reduction of 86.8% in FOB use, which was a similar reduction found in other published studies.
AB - Objective: To compare the incidence of fiberoptic bronchoscope (FOB) use (1) during verification of initial placement and (2) for reconfirmation of correct placement following repositioning, when either a double-lumen tube (DLT) or video double-lumen tube (VDLT) was used for lung isolation during thoracic surgery. Design: A randomized controlled study. Setting: Single-center university teaching hospital. Participants: The study comprised 80 patients who were 18 years or older requiring lung isolation for surgery. Interventions: After institutional review board approval, patients were randomized prior to surgery to either DLT or VDLT usage. Attending anesthesiologists placed the Mallinckrodt DLT or Vivasight (ET View Ltd, Misgav, Israel) VDLT with conventional laryngoscopy or video laryngoscopy then verified correct tube position through the view provided with either VDLT external monitor or FOB. Measurements and Main Results: Data collected included: sex, body mass index, successful intubation and endobronchial placement, intubation time, confirmation time of tube position, FOB use, quality of view, dislodgement of tube, and ability to forewarn dislodgement of endobronchial cuff and complications. FOB use for verification of final position of the tube (VDLT 13.2% [5/38] v DLT 100% [42/42], p < 0.0001), need for FOB to correct the dislodgement (VDLT 7.7% [1/13] v DLT 100% [14/14], p < 0.0001), dislodgement during positioning (VDLT 61.5% [8/13] v DLT 64.3% [9/14], p = ns), dislodgement during surgery (VDLT 38.5% [5/13] v DLT 21.4% [3/14], p = ns), and ability to forewarn dislodgement of endobronchial cuff (VDLT 18.4% [7/38] v DLT 4.8% [2/42], p = 0.078). Conclusion: This study demonstrated a reduction of 86.8% in FOB use, which was a similar reduction found in other published studies.
KW - double-lumen endobronchial tubes (DLT)
KW - fiberoptic bronchoscope (FOB)
KW - one-lung ventilation
KW - thoracic anesthesia
KW - thoracic surgery
KW - video double-lumen endobronchial tubes (VDLT)
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U2 - 10.1053/j.jvca.2017.05.016
DO - 10.1053/j.jvca.2017.05.016
M3 - Article
C2 - 29074128
AN - SCOPUS:85032197044
SN - 1053-0770
VL - 32
SP - 267
EP - 274
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 1
ER -