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. 2020 Nov;12(11):6533-6541.
doi: 10.21037/jtd-20-1595.

Comparing the rate of fiberoptic bronchoscopy use with a video double lumen tube versus a conventional double lumen tube-a randomized controlled trial

Akinjide Onifade  1 , Dlorean Lemon-Riggs  1 , Aaron Smith  1 , Taylor Pak  1 , Jessica Pruszynski  2 , Scott Reznik  2 , Tiffany S Moon  1
Affiliations

Comparing the rate of fiberoptic bronchoscopy use with a video double lumen tube versus a conventional double lumen tube-a randomized controlled trial

Akinjide Onifade et al. J Thorac Dis. 2020 Nov.

Abstract

Background: Double lumen endotracheal tubes (DLT) are commonly used to provide single lung ventilation during thoracic surgery. A fiberoptic bronchoscope (FOB) is typically used to confirm accurate DLT placement. Accounting for initial purchase, maintenance, repair and cleaning, the use of an FOB can cost as much as $312 per procedure. The VivaSight DLT (VS-DLT) incorporates a built-in camera, which is aimed at reducing FOB use and its associated costs. In this study, we compared the rate of FOB use when intubating using either a VS-DLT or a conventional DLT (c-DLT).

Methods: This is a randomized controlled comparative study performed at a public county teaching hospital. A total of 50 patients were enrolled and randomly assigned to either a c-DLT (n=25) or a VS-DLT (n=25). The primary outcome was the rate of FOB use. Secondary outcomes included time to correct tube placement and incidence of malposition during surgery.

Results: Use of the VS-DLT required significantly less FOB use (28%) compared to use of the c-DLT (100%). While there was no difference in the ease of intubation, the time to correct tube placement was significantly faster using a VS-DLT (54 vs. 156 s, P<0.001). Additionally, the incidence of tube malposition was significantly reduced in the VS-DLT group.

Conclusions: This study demonstrated a significantly lower rate of FOB use when using a VS-DLT compared to a c-DLT. Placement of the VS-DLT was significantly quicker and malposition during surgery occurred significantly less than with the c-DLT. While intubating with a VS-DLT provides clinical benefits, it may not result in significant cost reductions when compared to a c-DLT.

Keywords: Single lung ventilation; VivaSight; double lumen tube; thoracic surgery.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-1595). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Rate of fiberoptic bronchoscope use with VS-DLT versus c-DLT. VATS, video-assisted thoracoscopic surgery; c-DLT, conventional double lumen tube; VS-DLT, VivaSight double lumen tube.
Figure 2
Figure 2
VivaSight DLT view with a clear view (left) and obstructed by secretions (right). DLT, double lumen tube.
See this image and copyright information in PMC

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