Article Data

  • Views 463
  • Dowloads 124

Original Research

Open Access

One lung ventilation: double-lumen tube with vs. without carinal hook

  • IZTOK POTOČNIK1
  • LEA ANDJELKOVIĆ1
  • JASMINA MARKOVIČ-BOŽIČ1

1Clinical Department of Anaesthesiology and Surgical Intensive Therapy, University Medical Centre Ljubljana, Slovenia

DOI: 10.22514/SV141.052018.4 Vol.14,Issue 1,March 2018 pp.27-29

Published: 27 March 2018

*Corresponding Author(s): IZTOK POTOČNIK E-mail: iztok.potocnik@kclj.si

Abstract

Background. One lung ventilation (OLV) has become a standard procedure for the vast majority of interventions in pulmonary surgery. The most commonly used are left sided double-lumen tubes (DLTs) which are placed into the left main bronchus and the right or left lung can be isolated.

The aim of our study was to compare DLTs with and without a hook.

Materials and methods. Fifty-four patients undergoing lung resection were included in the randomized, controlled, single-blinded study. Recruited patients were randomly al-located to each group (hook/without hook). Demographic data, procedural data, type of tube used, and difficult intubation criteria were recorded. Complications, according to intubation and position of the tube, were also recorded. After the operation, we aske patients about a sore throat, hoarseness, haemoptysis and their satisfaction with the procedure.

Results. Baseline characteristics were well balanced between groups. Time to place DLT was shorter in the group without a hook (47.7±45.5 vs 15.8±15.1s; P=0.01). The incidence of adequate positioning at the first attempt was higher in the group with a hook and the repositioning rate was high-er in the group without a hook (22.22 vs 59.25%; P=0.004). Patients in both groups suffered similar incidences of hoarseness, sore throat or postoperative haemoptysis (5/5/1 vs 3/3/0; P = 0.44). Patient satisfaction was higher in the group without a hook (31.85% vs 34.81%;0.03).

Conclusion. The study showed the advan-tage of DLTs without a hook in comparison with DLTs with a hook. In our institution we decided to use DLTs without a hook, with fiberoptic control.


Keywords

double-lumen tube, carinal hook, pulmonary surgery

Cite and Share

IZTOK POTOČNIK,LEA ANDJELKOVIĆ,JASMINA MARKOVIČ-BOŽIČ. One lung ventilation: double-lumen tube with vs. without carinal hook. Signa Vitae. 2018. 14(1);27-29.

References

1. Clayton-Smith A, Bennett K, Alston RP, Adams G, Brown G, Hawthorne T, et al. A Comparison of the Efficacy and Adverse Effects of Double-Lumen Endobronchial Tubes and Bronchial Blockers in Thoracic Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth 2015;29:955-66.

2. Campos JH. Lung isolation techniques. Anesthesiol Clin North America 2001 Sept; 19(3):455-74.

3. Pedoto A. How to choose the double-lumen tube size and side: the eternal debate. Anesthesiol Clin 2012 Dec; 30(4):671-81.

4. Carlens E. A new flexible double-lumen catheter for bronchospirometry. J Thorac Surg 1949;18:742-6.

5. Bauer C, Winter C, Hentz JG, Ducrocq X, Steib A, Dupeyron JP. Bronchial blocker compared to double lumen tubes for one- lung ventilation during thoracoscopy. Acta Anaesthesiol Scandi 2001;45:250-4.

6. Campos JH, Hallam EA, Van Natta T, Kernstine KH. Devices for lung isolation used by anesthesiologists with limited experience: comparison of double-lumen endotracheal tube, Univent torque blocker, and Arndt wire guided endotracheal blocker. Anesthesiol-ogy 2006;104:261-6.

7. Oberhofer D, Majerić-Kogler V. Comparison between the rubber Carlens tube and the polyvinylchloride Robertshaw tube for endo-bronchial intubation. Lijec vjesn 1999 Nov-Dec;121(11-12):345-51.

8. Klein U, Karzai W, Bloos F, Wohlfarth M, Gottschall R, Fritz H, et al. Role of fiberoptic bronchoscopy in conjunction with the use of double-lumen tubes for thoracic anesthesia: a prospective study. Anesthesiology 1998 Feb;88(2):346-50.

9. Slinger PD. Fiberoptic bronchoscopic positioning of double-lumen tubes. J Cardiothorac Anesth 1989 Aug;3(4):486-96.

10. Brodsky JB. Fiberoptic bronchoscopy need not be a routine part of double-lumen tube placement. Curr Opin Anaesthesiol 2004 Feb;17(1):7-11.

11. Cohen E. Double-lumen tube position should be confirmed by fiberoptic bronchoscopy. Curr Opin Anaesthesiol 2004 Feb;17(1):1-6.

12. Narayanaswamy M, McRae K, Slinger P, Dugas G, Kanellakos GW, Roscoe A, Lacroix M. Choosing a lung isolation device for tho-racic surgery: a randomized trial of three bronchial blockers versus double-lumen tubes. Anesth Analg 2009 Apr;108(4):1097-101

13. Fitzmaurice BG, Brodsky JB. Airway rupture from double lumen tubes. J Cardiothoracic Vasc Anesth 1999;13:322-9.

14. Potocnik I, Kupsch A, Novak-Jankovic V. Iatrogenic rupture of the trachea caused by double Lumen tube intubation. Cent Eur J Med 2010;5:737.

15. Dumans-Nizard V, Parquin JF, Moyer JD, Dreyfus JF, Fischler M, Le Guen M. Left double-lumen tube with or without a carinal hook. A randomised controlled trial. Eur J Anaesthesiol 2015;32:418-24.

16. Novak-Jankovic V. Standardni operativni postopki (SOP) v anesteziologiji, reanimatologiji in perioperativni intenzivni medicini. Ljubljana: Univerzitetni klinični center, Klinični oddelek za anesteziologijo in intenzivno terapijo operativnih strok, Kirurška klinika, 2009.

17. Mourisee J, Liesveld J, Verhagen A, Van Rooij G, Van der Heide S, Schuurbiers-Siebers O, Van der Heijden E. Efficiency, efficassy, and safety of EZ-blocker compared with left-sided double-lumen tube for one-lung ventilation. Anesthesiology 2013;118:550-61.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

    Top