Bronchial Blocker Versus Left Double-Lumen Endotracheal Tube for One-Lung Ventilation in Right Video-Assisted Thoracoscopic Surgery

Lu, Yao; Dai, Wei; Zong, Zhi‐Hong; Xiao, Yimin; Wu, Di; Liu, Xuesheng; Wong, Gordon Tin Chun

doi:10.1053/j.jvca.2017.07.026

Cited by 54 publications

(44 citation statements)

References 15 publications

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“…While comparing the techniques used for lung isolation, safety and e ciency should be considered. The adequacy of lung collapse affects surgical exposure and is a criterion for the assessment of successful OLV 15 . In the present study, CT-guided endobronchial blocker placement achieved similar adequacy of lung collapse as compared with bronchoscopy-guided blocker placement in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

CT 3-Dimentional Airway Reconstruction-guided Intraluminal Placement of Endobronchial Blocker in Pediatric Patients: A Randomized Controlled Study

Zhang

Tan

et al. 2020

Preprint

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Background: The one-lung ventilation (OLV) with endobronchial blocking is commonly used in anesthesia for pediatric thoracic surgery. Bronchoscopy is commonly used to guide the endobronchial blocker placement. However, when bronchoscopy is not applicable, the proper placement of endobronchial blocker is challenging. The computed tomography (CT) 3-dimentional reconstruction may be used to accurately measure the airway of pediatric patients. The present study was aimed to propose a new approach of CT 3-dimentional airway reconstruction-guided endobronchial blocker placement in pediatric patients and to determine its efficiency in clinical application.Methods: A total of 127 pediatric patients of 0.5-3 years old who would undergo elective thoracic surgery under OLV were randomized into the bronchoscopy group and the CT group. The degree of lung collapse, postoperative airway mucosal injury, pulmonary infection within 72 h after surgery, trachyphonia after tracheal extubation, durations of postoperative mechanical ventilation, intensive care unit (ICU) stay, and hospitalization, the successful rate of the first blocker positioning, and the required time and repositionings for successful blocker placement were compared between the two groups.Results: The degree of lung collapse, postoperative airway mucosal injury, pulmonary infection within 72 h after surgery, trachyphonia after tracheal extubation, durations of postoperative mechanical ventilation, ICU stay, and hospitalization were similar between the two groups (all P > 0.05).Conclusions: For pediatric patients who would undergo surgery with OLV, preoperative CT 3-dimentional airway reconstruction could be used to guide endobronchial blocker placement, with a blocking efficiency similar to that of bronchoscopy-guided blocker placement.The trial was registered prior to patient enrollment at China Clinical Trial Registry (http://www.chictr.org.cn/showproj.aspx?proj=4344, Principal investigator: Yingyi Xu, Registration number: ChiCTR-TRC-14005232, Date of registration: 12 August 2014).

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Section: Discussionmentioning

confidence: 99%

CT 3-Dimentional Airway Reconstruction-guided Intraluminal Placement of Endobronchial Blocker in Pediatric Patients: A Randomized Controlled Study

Zhang

Tan

et al. 2020

Preprint

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“…Both strategies would mandate one-lung ventilation in the context of hypoxia and acute airway bleeding in a severely emphysematous patient. This may well have led to significant shunt and hypoxia [4,5]. The fixed neck flexion precluded rigid bronchoscopy for direct visualisation and haemorrhage control.…”

Section: Discussionmentioning

confidence: 99%

Acute life‐threatening massive haemoptysis in a patient with a predicted difficult airway and emphysematous lung disease

et al. 2018

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Summary A 61‐year‐old male presented to the emergency department with acute life‐threatening massive haemoptysis. His previous history was remarkable for extensive mandibular and retromolar resection and reconstruction for squamous cell carcinoma ten years previously. A recent computed tomography scan of the thorax showed severe bullous emphysema. There were several features suggestive of a difficult airway, such as reduced mouth opening and fixed neck flexion. A technique was required, therefore, that avoided the use of a double‐lumen tube or bronchial blocker. We report the successful use of a post‐carinal Aintree intubation catheter to facilitate oxygenation of the right lung with a concurrent bronchially‐advanced single‐lumen tracheal tube to isolate and ventilate the left lung. This temporising strategy successfully bridged the life‐threatening phase of acute haemoptysis and the patient later received definitive treatment for a newly‐identified right upper lobe adenocarcinoma.

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“…Lung separation is often required for thoracic surgery to improve the visibility of the surgical field (Lu et al 2018). New anaesthetic technologies for lung separation seem to provide advantages for lung isolation, surgical visualisation and access to the operative lung (Schlichting et al 2016).…”

Section: Introductionmentioning

confidence: 99%

“…New anaesthetic technologies for lung separation seem to provide advantages for lung isolation, surgical visualisation and access to the operative lung (Schlichting et al 2016). Different strategies can be used to achieve one-lung ventilation such as double-lumen endotracheal tube or a bronchial blocker inserted into a single-lumen endotracheal tube (Lu et al 2018). In a prospective study, with 71 adults, time to intubation with visual confirmation of correct tube position was significantly reduced using VivaSight™ video double-lumen endotracheal tube (vDLT) compared with the conventional double-lumen tube, median 51 seconds (53–118) versus 264 seconds (160–490) (Levy‐Faber et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of time to intubation and rate of success for different healthcare professionals using a double-lumen left-sided endotracheal video tube: A prospective observational study

Pedersen

Green

Bigler

et al. 2020

Journal of Perioperative Practice

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Intubation with a double-lumen left-sided endotracheal video tube has been the standard procedure for nearly five years in the Department of Cardiothoracic Surgery, Copenhagen University Hospital, but no systematic evaluations have been done. For a 12-month period ending November 2017, data were collected from 579 consecutive patients, scheduled for thoracic surgery with a requirement for one-lung ventilation; 35 anaesthetist trainees (nurses or doctors) (287 cases), 27 nurse anaesthetists (239 cases) and 8 anaesthesiologists (53 cases) managed intubation with a double-lumen tube. Time to intubation was relatively equal across healthcare professionals with a mean time of 53 (anaesthetist trainees), 40 (nurse anaesthetists) and 63 (anaesthesiologists) seconds. The shorter time for nurse anaesthetists and prolonged time for anaesthesiologists might be due to the small number of cases and the fact that anaesthesiologists carried out 60% of the cases, where a third attempt was needed, and 25% of cases for the anaesthesiologists were assessed to a Cormack-Lehane grade of 3 or 4 compared to 6% for anaesthetist trainees and 5% for nurse anaesthetists. The rate of successful placement in the first attempt of placing the double-lumen left-sided endotracheal video tube was high, which emphasises that intubation with a double-lumen left-sided endotracheal video tube is suitable for use by different healthcare professionals.

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Bronchial Blocker Versus Left Double-Lumen Endotracheal Tube for One-Lung Ventilation in Right Video-Assisted Thoracoscopic Surgery

Cited by 54 publications

References 15 publications

CT 3-Dimentional Airway Reconstruction-guided Intraluminal Placement of Endobronchial Blocker in Pediatric Patients: A Randomized Controlled Study

CT 3-Dimentional Airway Reconstruction-guided Intraluminal Placement of Endobronchial Blocker in Pediatric Patients: A Randomized Controlled Study

Acute life‐threatening massive haemoptysis in a patient with a predicted difficult airway and emphysematous lung disease

Evaluation of time to intubation and rate of success for different healthcare professionals using a double-lumen left-sided endotracheal video tube: A prospective observational study

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