The use of ETView endotracheal tube for surveillance after tube positioning in patients undergoing lobectomy, randomized trial

Abstract

The ETView tracheoscopic ventilation tube (TVT) is a tracheal tube (TT) incorporating a video camera and a light source in its tip. The view from the tip appears continuously on a portable monitor in the anesthesia area. We evaluated the effectiveness and usefulness of the single/double ETView TVT in monitoring the tracheal tube position during general anesthesia undergoing video-assisted thoracoscopic lobectomy.Eighty-three patients with pulmonary bullae (American Society of Anesthesiologists (ASA) I-III) undergoing lobectomy, with general anaesthesia, were included. Patients were randomly assigned to 3 groups, based on the tube ETView double-lumen tube (VDT), ETView single-lumen tube (VST), or traditional double lumen tube (DT).All 83 patients’ intubations were successful to achieve 1-lung ventilation: 74 patients at the first attempt (22/26 in VDT, 26/28 in VST, 26/29 in DT group) and 9 patients at the second attempt. The time to achieve 1-lung ventilation with the VDT was 58.5 ± 21.5 (mean ± SD) seconds, the VST was 38.2 ± 10.1 (mean ± SD) seconds, and the DT group was 195.5 ± 40.3 (mean ± SD) seconds. During operations, the ETView tubes provided continuous airway visualization in all patients; a good view was obtained in 24/25 patients in VDT/VST, moderate in 4/12 patients in VDT/VST, and poor in 1/1 patients in VDT/VST. When the patient left the postanesthesia care unit, all had sore throat and 26/15/25 patients in VDT/VST/DT group had hoarseness. All had good outcomes of the surgical operations.We found the ETView tube to be helpful in the endotracheal intubation and continuous surveillance of tube position in patients with video-assisted thoracoscopic lobectomy. The ETView single lumen endotracheal tube had fewer associated complications and is superior to the 2 double-lumen tubes.

Different classes of videoscopes and direct laryngoscopes for double-lumen tube intubation in thoracic surgery: A systematic review and network meta-analysis

“…However, the intubation of DLT is challenging because it is much larger and stiffer in structure than a conventional single-lumen tracheal tube [1]. Moreover, patients undergoing thoracic surgery usually have limited tolerance for apnea; thus, precise and rapid tube insertion is a priority in such patients [2].…”

Efficacy and Safety of Video-Laryngoscopy versus Direct Laryngoscopy for Double-Lumen Endotracheal Intubation: A Systematic Review and Meta-Analysis

“…Then, the full texts were reviewed, and 32 studies were excluded because they did not involve Macintosh direct laryngoscope as a comparator group, consisted of manikin trials, involved different interventions, or were reviews or meta-analyses. Ultimately, 25 studies [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ] published in the period of 2010–2021 were included in this meta-analysis.…”