A randomised trial comparing real-time double-lumen endobronchial tube placement with the Disposcope^® with conventional blind placement

Abstract

Double-lumen endobronchial tube placement is challenging. This study compared double-lumen tube placement with the Disposcope , a wireless videostylet allowing real-time visualisation, with conventional blind placement. Patients undergoing elective thoracic surgery with normal airways requiring one-lung ventilation were randomly allocated into two groups (27 patients in each group). The Disposcope was used to assist left-sided double-lumen tube placement in one group, and conventional blind placement was performed in the control group. Placement in both groups was checked with fibreoptic bronchoscopy. The Disposcope-assisted group had a shorter total mean (SD) placement time (18.6 (2.5) s vs. 21.4 (2.9) s, p < 0.001), laryngoscopy to end of auscultation time (83.4 (3.0) s vs. 93.9 (5.7) s, p < 0.001) and total operation time (130.7 (6.1) s vs. 154.5 (6.3) s, p < 0.001). In the Disposcope-assisted group, the double-lumen tube was inserted in the correct side in all patients (100.0%), whereas in the conventional group, the double-lumen tube was placed in the correct side in 25 (92.6%) patients and in the wrong side in 2 (7.4%) patients; the difference was not significant (p = 0.150). In the Disposcope-assisted group, the double-lumen tube was inserted to the optimal depth in 24 (88.9%) patients, whereas in the conventional group it was inserted to the optimal depth in one (4.0%) patient. The Disposcope increased the success rate of double-lumen tube placement, and shortened the total operation time when compared with standard placement with confirmation using fibreoptic bronchoscopy, and may replace the conventional method.

Videolaryngoscopy vs. Macintosh laryngoscopy for double‐lumen tube intubation in thoracic surgery: a systematic review and meta‐analysis

“…A recent study reported a wireless video stylet allowing real‐time visualisation during double‐lumen tube placement. The authors found that the stylet could help correctly position the double‐lumen tube and also saved time .…”

A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

“…In trauma patients wearing a semi-rigid neck collar, the Disposcope endoscope demonstrated a promising ability to guide successful endotracheal intubation [6]. Another study showed that the Disposcope endoscope could also be applied successfully in double-lumen tube placement [7].…”

Comparison of Fiberoptic Bronchoscope and Disposcope Endoscope in Cohen Endobronchial Blocker Placement

“…In another study, Kamburoglu et al [11] investigated the efficacy of conventional FOB versus DE for the confirmation of the correct position of the DLT and reported shorter confirmation time with DE. Similarly, Chen et al [12] compared conventional blind tube placement versus DE using DLTs and showed higher success rates and shorter duration of placement with DE.…”