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Randomized Controlled Trial
. 2020 Oct;48(10):300060520964369.
doi: 10.1177/0300060520964369.

Lung sonography can improve the specificity of determination of left-sided double-lumen tracheal tube position in both novices and experts: a randomised prospective study

Jun-Young Chung  1 , YoonJu Go  2 , Yong Seok Jang  1 , Bong-Jae Lee  1 , Hyungseok Seo  1
Affiliations
Randomized Controlled Trial

Lung sonography can improve the specificity of determination of left-sided double-lumen tracheal tube position in both novices and experts: a randomised prospective study

Jun-Young Chung et al. J Int Med Res. 2020 Oct.

Abstract

Objective: Lung sonography can be helpful to determine the position of a left-sided double-lumen tube (DLT). However, clinical experience is required for correct assessment. We investigated whether lung sonography can improve the diagnostic efficacy of determining the DLT position in novices and experts.

Methods: In this randomised prospective clinical study, 88 patients were allocated to two groups using auscultation or lung sonography for initial assessment of the DLT position. In each group, two repeated assessments were performed; the first was performed by a novice, and the second was performed by an expert. The final DLT position was confirmed by fibre-optic bronchoscopy. The primary outcome was the diagnostic efficacy (including overall accuracy, sensitivity, and specificity) in confirming the DLT position.

Results: In both the novices and experts, the specificity of determining the DLT position was significantly higher with lung sonography than auscultation (60.0% vs. 21.7% and 66.7% vs. 37.5%, respectively). Additionally, the predictability of an incorrect position was similar between the novices and experts using lung sonography (area under the curve of 0.665 and 0.690, respectively).

Conclusions: Lung sonography can improve the diagnostic efficacy of detecting an incorrect DLT position in both novices and experts.

Keywords: Auscultation; double-lumen tube; expert; lung sonography; novice; one-lung ventilation.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
CONSORT flow chart.
Figure 2.
Figure 2.
Comparison of accuracy, sensitivity, and specificity between patients using auscultation and lung sonography for initial double-lumen tube position assessment. Left: results of novices. Right: results of experts.
See this image and copyright information in PMC

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