Evaluation of the Double-Lumen Tube Vivasight-DL (DLT-ETView): A Prospective Single-Center Study

Abstract

Objectives: VivaSight-DL (DLT-ETView) is a single-use double-lumen tube (DLT) with an integrated camera visualizing the carina continuously, which could reduce the need for a routine fiberoptic bronchoscopy. The objective of this study was to evaluate its rate of correct positioning.

Design: A prospective, observational study.

Setting: A university hospital.

Participants: 170 patients undergoing a thoracic surgical procedure.

Interventions: Selective left bronchus intubation.

Measurements and main results: The main outcome measure was a double criteria assessed by fiberoptic bronchoscopy: the bronchial cuff in the left main bronchus and end of the bronchial lumen upstream of the lobar bifurcation. Between September 2013 and April 2014, 84 patients of the planned 170 were included. Seven patients were excluded: 3 for failed intubation, 3 for protocol violation, and 1 because the DLT melted before insertion. The study was terminated after this event. Seventy-six patients (99%) had correct positioning, with a median margin of safety of 20 mm (interquartile range: 15-27) in the surgical position. In 40 patients (53%), malpositioning required mobilization of the tube at least once intraoperatively.

Conclusions: The tube was well positioned in almost all patients. Continuous visualization of the carina is a major improvement for patient care as intraoperative displacement can be diagnosed immediately and corrected. However, an incident induced premature ending of the study.

Keywords: VivaSight; bronchoscopy; double-lumen tube; intratracheal; intubation; one-lung ventilation.