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J Cardiothorac Vasc Anesth. 2014 Aug;28(4):870-2. doi: 10.1053/j.jvca.2013.11.011. Epub 2014 Mar 20.

A retrospective evaluation of the use of video-capable double-lumen endotracheal tubes in thoracic surgery.

Author information

1
Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: jsheir@mdanderson.org.
2
Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.

Abstract

OBJECTIVE:

The objective of this study was to evaluate whether the use of a video double-lumen tube reduced the need for fiberoptic bronchoscopy for (1) verification of initial tube placement and for (2) reverification of correct placement after repositioning for thoracotomy.

DESIGN:

A single-center retrospective study.

SETTING:

Thoracic surgery in a medical university hospital.

PARTICIPANTS & INTERVENTIONS:

After institutional review board approval, 29 patients who underwent thoracic surgical procedures using video double-lumen tubes were included in the final retrospective analysis.

MEASUREMENTS AND MAIN RESULTS:

For 27 (93.2%) patients, the use of fiberoptic bronchoscopy was not needed either for initial placement or for verification of correct video double-lumen tube placement upon final positioning of the patient. However, for two patients, fiberoptic bronchoscopy was needed: for (1) one patient with severe left mainstem bronchus distortion as a result of a large left upper lobe tumor, and (2) a second patient with secretions that were difficult to clear.

CONCLUSION:

This study demonstrates that the video double-lumen tube requires significantly less (6.8%) fiberoptic use for both initial placement and verification of final position, in stark contrast to standard practice in which bronchoscopy is always used to verify final positioning of the double-lumen tube. As opposed to intermittent bronchoscopy, the continuous visualization offered by an embedded camera may confer an added measure of safety.

KEYWORDS:

double-lumen tubes; fiberoptic bronchoscopy; fiberoptics; one-lung ventilation; thoracic anesthesia; thoracic surgery; video-double-lumen endobronchial tube

PMID:
24656617
DOI:
10.1053/j.jvca.2013.11.011
[Indexed for MEDLINE]

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