scholarly journals Comparison of Double-Lumen Tube and EZ-Blocker for Lung Separation in Thoracic Surgery - A Randomised Controlled Clinical Trial

2021 ◽  
Author(s):  
Joachim Risse ◽  
Karsten Szeder ◽  
Ann-Kristin Schubert ◽  
Thomas Wiesmann ◽  
Hanns-Christian Dinges ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Double Lumen Tube ◽  
Lung Collapse ◽  
Double Lumen ◽  
Lumen Tube ◽  
Trial Register ◽  
German Clinical Trial Register ◽  
Randomised Controlled ◽  
Clinical Trial Register

Abstract Background:Double lumen tube (DLT) intubation is the most commonly used technique for lung separation. Bronchial blockers (BB) are an alternative, especially for difficult airways. The EZ-bronchial blocker (EZB) is the newest device of the BB family. Methods:A randomised, controlled trial was conducted in 80 patients undergoing elective thoracic surgery using DLT or SLT plus EZB for lung separation (German Clinical Trial Register DRKS00014816). The objective of the study was to compare the clinical performance of EZB with DLT. Primary endpoint was total time to successful lung separation. Secondary endpoints were time subsections, quality of lung collapse, difficulty of intubation, any complications during the procedure, incidence of objective trauma of the oropharynx and supraglottic space and intubation-related subjective symptoms.Results:74 patients were included, DLT group (n = 38), EZB group (n = 36). Median total time for lung separation [IQR] in DLT group was 234 seconds [207 to 294] versus 298 seconds [243 to 369] in EZB group (P=0.007). Quality of lung collapse was equal in both groups, DLT group 89.5% were excellent vs. 83.3 % in the EZB group (P=0.444). Inadequate lung collapse in five patients of the EZB group resulted in unsuccessful repositioning attempts and secondary DLT placement. Endoscopic examinations revealed significantly more carina trauma (P=0.047) and subglottic haemorrhage (P=0.047) in the DLT group. Additionally, postoperative subjective symptoms (sore throat, hoarseness) were more common in the DLT group, as were speech problems.Conclusions:Using the EZB results in prolonged lung separation compared to DLT, prima facie with equal quality of lung collapse for the thoracic surgeon. Five crossover cases demonstrated the superiority of the use of left-sided DLT especially in the indication for EZB for a right open thoracotomy or right video-assisted thoracoscopic surgery (VATS). Using the EZB showed only little evidence for reducing objective airway trauma e.g. less carina trauma as well as subjective complaints.Trial registration:German Clinical Trial Register DRKS00014816, prospectively registered on 07.06.2018https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014816

scholarly journals O-100ISOLATED LUNG COLLAPSE IN TWO STAGES WITH BRONCHIAL BLOCKER: EQUIVALENT TO DOUBLE-LUMEN TUBE?

2013 ◽  
Vol 17 (suppl_1) ◽  
pp. S27-S27
Author(s):  
José Luis Carrasco Del Castillo ◽  
J. Lemieux ◽  
J. Somma ◽  
M. Conti ◽  
N. Gagné ◽  
...  
Keyword(s):  
Double Lumen Tube ◽  
Bronchial Blocker ◽  
Lung Collapse ◽  
Double Lumen ◽  
Lumen Tube ◽  
Two Stages

Randomized Clinical Trial Comparing Double-Lumen Tube and EZ-Blocker for Single-Lung Ventilation

2012 ◽  
Vol 56 (4) ◽  
pp. 161-162
Author(s):  
K. Ruetzler ◽  
G. Grubhofer ◽  
W. Schmid ◽  
D. Papp ◽  
S. Nabecker ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
Double Lumen ◽  
Lumen Tube ◽  
Single Lung Ventilation

The ventilation parameters during the Nuss procedure for repair of pectus excavatum

2020 ◽  
Vol 26 (2-3) ◽  
pp. 28-37
Author(s):  
I.I. Myhal ◽  
◽  
U.A. Fesenko ◽  
A.O. Dvorakevich ◽  
A.A. Albokrinov ◽  
...  
Keyword(s):  
Pectus Excavatum ◽  
Double Lumen Tube ◽  
Nuss Procedure ◽  
Airway Protection ◽  
Point Scale ◽  
Double Lumen ◽  
Lumen Tube ◽  
Single Lumen ◽  
Group D

The ventilation parameters during the Nuss procedure for repair of pectus excavatum depend on surgical procedures and airway protection technique. The aim of the study: analyzing the ventilation parameters during the Nuss procedure for repair of pectus excavatum according to the airway protection technique. Material and Methods. The observational prospective study included 60 adolescents (boys/girls=47/13) who had undergone the Nuss procedure for repair of pectus excavatum under a combination of general anesthesia with different types of regional blocks. The patients were randomized into two groups (n=20 in each) according to the airway protection technique: Group S (n=32) where the patients were intubated with a standard single-lumen tube, and capnothorax with 4-6 mmHg intrapleural pressure was applied; Group D (n=28) where the patients were intubated with a double-lumen tube, and open pneumothorax was applied without additional pressure in the thoracic cavity. All patients were ventilated using PCV with changing of the parameters in relevance with EtCO2. The following parameters were analyzed: peripheral blood saturation (SpO2), inspiratory fractional oxygen concentration (FiO2), end-tidal carbon dioxide partial pressure (EtCO2), tidal volume (Tv), peak inspiratory pressure (PIP), positive end-expiratory pressure (PEEP), the number of repeated intubation attempts, and the quality of operation field visualization checked by surgeon with a 5-point scale. Results and Discussion. During capno/pneumothorax and bar rotation, in both groups SpO2 decreased up to 95%, which required increasing FiO2 up to 70% in Group D, and up to 63% in Group S (р=0.04). Applying capno/pneumothorax lead to reduced Tv, which was 52 ml less in Group D than in Group S (р=0.0001). The levels of EtCO2, PIP, and PEEP were comparable in both groups at all stages of the surgery. The number of repeated intubation attempts was- 1 case (3,1%) in group S, and 2 cases (7,1%) in group D: c2 = 0,51; p=0.48, the adjusted c22 = 3.84 for p <0.05. The quality of operation field visualization evaluated by the surgeons with the 5-point scale was better in Group D (4.5 points), than in Group S - 3 points (р<0.000001) at all stages. Conclusions. The one-lung ventilation using double-lumen left-side tube provides better operating field visualization than ventilation throw single-lumen tube with capnothorax. Both techniques supply adequate ventilation and oxygenation parameters. Key words: tracheal intubation, ventilation, pectus excavatum, Nuss procedure

scholarly journals Randomized clinical trial comparing double-lumen tube and EZ-Blocker ® for single-lung ventilation

2011 ◽  
Vol 106 (6) ◽  
pp. 896-902 ◽  
Author(s):  
K. Ruetzler ◽  
G. Grubhofer ◽  
W. Schmid ◽  
D. Papp ◽  
S. Nabecker ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Lung Ventilation ◽  
Double Lumen Tube ◽  
Double Lumen ◽  
Lumen Tube ◽  
Single Lung Ventilation
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