Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 Jun 1;111(6):3989-4001.
doi: 10.1097/JS9.0000000000002378. Epub 2025 May 12.

Comparison of clinical characteristics of different ventilation devices for one-lung ventilation in adults: a network meta-analysis

Haisu Li  1   2 , Hezhi Wang  1   2 , Conglan Wang  1   2 , Yuhan Huang  1   2 , Rui Yuan  1   2 , Xiaoyi Zhao  1   2 , Ying Xu  1   2
Affiliations
Comparative Study

Comparison of clinical characteristics of different ventilation devices for one-lung ventilation in adults: a network meta-analysis

Haisu Li et al. Int J Surg. .

Abstract

Objectives: Different ventilation devices, including double-lumen tube (DLT), video DLT (VDLT), and various bronchial blockers (BBs), were used for one-lung ventilation (OLV). This study aimed to assess the clinical characteristics of 12 OLV devices to identify the optimal ventilation strategy for different situations.

Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched following the PICOS principle to retrieve relevant randomized controlled trials (RCTs) up to 18 November 2023. Network meta-analysis was conducted using R 4.3.2, StataSE15, and Review Manager 5.3 software to compare the clinical characteristics of these OLV devices, including the quality of lung collapse, malposition rate, time for device placement, the success of the first intubation attempt, postoperative sore throat, and hoarseness.

Results: In summary, this study involved 33 RCTs with a total of 2177 patients to evaluate the clinical characteristics of 12 ventilation devices. Compared to the Arndt BB, DLT provided higher lung collapse quality and was less prone to malposition. According to the Ranking probabilities, the VDLT had a shorter placement time, while the Coopdech BB (CBB) had a higher success rate on the first intubation attempt. The Cohen Flex-Tip BB resulted in less hoarseness, and the CBB had a lower incidence of sore throat.

Conclusion: DLT demonstrated reliable lung collapse quality. VDLT allowed for quicker placement and continuous airway monitoring. BBs had fewer complications and were easier to place but had a higher risk of malposition. Therefore, choosing an OLV device depends on the patient's clinical status and surgical needs.

Keywords: Bayesian network meta-analysis; airway management; bronchial blocker; double lumen tube; one-lung ventilation; video double lumen tube.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram showing selection of studies.
Figure 2.
Figure 2.
Network diagram between different ventilation devices.
Figure 3.
Figure 3.
Results of network meta-analysis [OR/MD, (95% CI)]. (*) indicates statistical significance.
Figure 4.
Figure 4.
Results of SUCRA.
Figure 5.
Figure 5.
Forest plot for the results of network meta-analysis [OR/MD, (95% CI)].
Figure 6.
Figure 6.
Two-dimensional plot of clinical characteristics.
See this image and copyright information in PMC

References

    1. Campos JH. Current techniques for perioperative lung isolation in adults. Anesthesiology 2002;97:1295–301. - PubMed
    1. Cohen E. Current practice issues in thoracic anesthesia. Anesth Analg 2021;133:1520–31. - PubMed
    1. Zani G, Stefano M, Tommaso BF, et al. How clinical experience leads anesthetists in the choice of double-lumen tube size. J Clin Anesth 2016;32:1–3. - PubMed
    1. Falzon D, Alston RP, Coley E, Montgomery K. Lung isolation for thoracic surgery: from inception to evidence-based. J Cardiothorac Vasc Anesth 2017;31:678–93. - PubMed
    1. Brassard CL, Lohser J, Donati F, Bussières JS. Step-by-step clinical management of one-lung ventilation: continuing professional development. Can J Anaesth 2014;61:1103–21. - PubMed

Publication types

MeSH terms

LinkOut - more resources