A Retrospective Evaluation of the Use of Video-Capable Double-Lumen Endotracheal Tubes in Thoracic Surgery

作者：Heir Jagtar Singh^*; Purugganan Ron; Jackson Timothy A; Norman Peter H; Cata Juan P; Kosturakis Alyssa; Thakar Dilip

来源：Journal of Cardiothoracic and Vascular Anesthesia, 2014, 28(4): 870-872.

DOI：10.1053/j.jvca.2013.11.011

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

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. %26lt;br%26gt;Design: A single-center retrospective study. %26lt;br%26gt;Setting: Thoracic surgery in a medical university hospital. %26lt;br%26gt;Participants %26 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. %26lt;br%26gt;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. %26lt;br%26gt;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.

• 出版日期2014-8