Cardiothoracic & vascular anesthesia
A Clinical Comparison of 2 Bronchial Blockers Versus Double-Lumen Tubes for One-Lung Ventilation
Authors' conclusion
The LCS was comparable among the 3 devices until 20 minutes after pleural opening, when better scores were obtained in the bronchial blocker groups. Lung isolation was achieved fastest with the DLT. The EZB had the highest incidence of cases requiring >2 intraoperative repositions, mostly occurring in R-sided surgery. For L-sided surgery, the EZB performed equally to the UB.
Study context
- Population
- Patients undergoing elective open thoracotomy or video-assisted thoracoscopic surgery, single tertiary university-affiliated hospital
- Participants
- 89 patients
- Comparison
- EZ blocker vs Fuji Uniblocker vs left-sided double-lumen tube for OLV
- Double lumen tube (DLT)n = 29reference
- EZ blocker (EZB)n = 30
- Uniblocker (UB)n = 30
- Primary endpoint
- Quality of lung collapse (Lung Collapse Score, 0 = no collapse to 10 = best collapse), assessed by surgeon
- Follow-up
- At pleural opening and 10 and 20 minutes thereafter
Methodological detailsprospective, single-centre, surgeon blinded to device
- Prospective
- Single-centre
- Surgeon blinded to device
Primary result
As reported in the abstract
DLT
9
median · IQR 8–9
EZB
9
median · IQR 9–10
UB
9.5
median · IQR 9–10
DLT vs EZB: P = 0.04 · DLT vs UB: P = 0.02
- Lung Collapse Score (LCS) at pleural opening not significantly different among groups
- P = 0.34
- LCS at 10 min after pleural opening not significantly different among groups
- P = 0.08
- LCS at 20 min significantly different among groups
- P = 0.02
Further findings
- Difficult placement — UB
- 23.3%
- Intraoperative repositioning — UB
- 50.0%
- Cases requiring >2 repositions — EZB
- 13.3%
Time to lung isolation
- Lung isolation achieved fastest in the DLT group
- P < 0.01
Difficult placement
- Frequency did not significantly differ among groups; most frequent in UB
Intraoperative repositioning
- Occurred most often with the UB
Cases requiring >2 repositions
- Greatest number in EZB
Preoperative airway measurements (CT) vs time to isolation or repositioning
- No differences between preoperative airway measurements and time to isolation or incidence of intraoperative repositioning among groups
Original publication
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