https://doi.org/10.4081/monaldi.2023.2700
Comparison of lung ultrasound technique versus clinical method to evaluate the accuracy of size and placement of left endobronchial double lumen tube in patients undergoing elective thoracic surgery: a prospective observational study
Submitted: July 5, 2023
Accepted: September 5, 2023
Published: September 18, 2023
Accepted: September 5, 2023
Abstract Views: 607
PDF_early view: 314
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Anthropometric measurements like height and gender have been frequently found to be inaccurate in prediction of size of double lumen tube (DLT). A tracheal ultrasonography (TUS) is a technique that can be used to predict the size of DLT and its correct placement for lung isolation. We aim to check the accuracy of ultrasound over clinical methods. This prospective study included 68 patients undergoing elective thoracic surgery requiring one-lung ventilation (OLV) with DLT. The groups were assessed for the size of DLT by either anthropometric measurement using height and gender (Group C) or ultrasound method (Group U). Further, the accuracy of placement of DLT was assessed through, either lung auscultation in group C or various ultrasonographic and ventilatory parameters such as lung isolation in the first attempt (lung sliding and lung pulse sign), oxygenation status and peak airway pressure, in group U. Surgeon satisfaction score was also compared in both the groups. The accuracy of predicted DLT size between Group C and Group U was statistically significant (p=0.044). In Group C, 56% of patients showed a mismatch between the predicted DLT size and the actual size required, while in Group U, the mismatch was only 32.4%. The accuracy of DLT placement through group C was 41% as compared to 79% in Group U. Surgeon satisfaction score was also significantly higher in Group U as compared to Group C (p=0.0028). Thus, our study suggests that tracheal and chest ultrasonography for DLT size selection and placement for lung isolation is superior to clinical methods.
Bahk JH, Lim YJ, Kim CS. Positioning of a double-lumen endobronchial tube without the aid of any instruments: an implication for emergency management. J Trauma 2000;49:899-902.
DOI: https://doi.org/10.1097/00005373-200011000-00018
Moloney JT, Fowler SJ, Chang W. Anesthetic management of thoracic trauma. Curr Opin Anaesthesiol 2008;21:41-6.
DOI: https://doi.org/10.1097/ACO.0b013e3282f2aadc
Smith GB, Hirsch NP, Ehrenwerth J. Placement of double-lumen endobronchial tubes. Correlation between clinical impressions and bronchoscopic findings. Br J Anaesth 1986;58:1317-20.
DOI: https://doi.org/10.1093/bja/58.11.1317
Cohen E. Double-lumen tube position should be confirmed by fiberoptic bronchoscopy. Curr Opin Anaesthesiol 2004;17:1-6.
DOI: https://doi.org/10.1097/00001503-200402000-00002
Klein U, Karzai W, Bloos F, et al. Role of fiberoptic bronchoscopy in conjunction with the use of double-lumen tubes for thoracic anesthesia: a prospective study. Anesthesiology 1998;88:346-50.
DOI: https://doi.org/10.1097/00000542-199802000-00012
Weaver B, Lyon M, Blaivas M. Confirmation of endotracheal tube placement after intubation using the ultrasound sliding lung sign. Acad Emerg Med 2006;13:239-44.
DOI: https://doi.org/10.1197/j.aem.2005.08.014
Brodsky JB, Macario A, Mark JB. Tracheal diameter predicts double-lumen tube size: a method for selecting left double-lumen tubes. Anesth Analg 1996;82:861-4.
Brodsky JB, Lemmens HJ. Tracheal width and left double-lumen tube size: a formula to estimate left-bronchial width. J Clin Anesth 2005;17:267-70.
DOI: https://doi.org/10.1016/j.jclinane.2004.07.008
Eldawlatly AA. Double lumen tube: Size and insertion depth. Saudi J Anaesth 2021;15:280-2.
DOI: https://doi.org/10.4103/sja.sja_192_21
Zhang C, Qin X, Zhou W, et al. Prediction of left double-lumen tube size by measurement of cricoid cartilage transverse diameter by ultrasound and CT multi-planar reconstruction. Front Med (Lausanne) 2021;8:657612.
DOI: https://doi.org/10.3389/fmed.2021.657612
Brodsky JB, Macario A, Mark JB. Tracheal diameter predicts double-lumen tube size: a method for selecting left double-lumen tubes. Anesth Analg 1996;82:861-4.
DOI: https://doi.org/10.1213/00000539-199604000-00032
Chow MY, Liam BL, Lew TW, et al. Predicting the size of a double-lumen endobronchial tube based on tracheal diameter. Anesth Analg 1998;87:158-60.
DOI: https://doi.org/10.1213/00000539-199807000-00033
Parab SY, Kumar P, Divatia JV, Sharma K. A prospective randomized controlled double-blind study comparing auscultation and lung ultrasonography in the assessment of double lumen tube position in elective thoracic surgeries involving one lung ventilation at a tertiary care cancer institute. Korean J Anesthesiol 2019;72:24-31.
DOI: https://doi.org/10.4097/kja.d.17.00081
Ramsingh D, Frank E, Haughton R, et al. Auscultation versus point-of-care ultrasound to determine endotracheal versus bronchial intubation: a diagnostic accuracy study. Anesthesiology 2016;124:1012-20.
DOI: https://doi.org/10.1097/ALN.0000000000001073
Parab SY, Divatia JV, Chogle A. A prospective comparative study to evaluate the utility of lung ultrasonography to improve the accuracy of traditional clinical methods to confirm position of left sided double lumen tube in elective thoracic surgeries. Indian J Anaesth 2015;59:476-81.
DOI: https://doi.org/10.4103/0019-5049.162983
Lichtenstein DA, Lascols N, Prin S, Mezière G. The "lung pulse": an early ultrasound sign of complete atelectasis. Intensive Care Med 2003;29:2187-92.
DOI: https://doi.org/10.1007/s00134-003-1930-9
Breitkreutz R, Seibel A, Zechner PM. Ultrasound-guided evaluation of lung sliding for widespread use? Resuscitation 2012;83:273-4.
DOI: https://doi.org/10.1016/j.resuscitation.2011.12.034
Lyon M, Walton P, Bhalla V, Shiver SA. Ultrasound detection of the sliding lung sign by prehospital critical care providers. Am J Emerg Med 2012;30:485-8.
DOI: https://doi.org/10.1016/j.ajem.2011.01.009
Sustić A, Protić A, Cicvarić T, Zupan Z. The addition of a brief ultrasound examination to clinical assessment increases the ability to confirm placement of double-lumen endotracheal tubes. J Clin Anesth 2010;22:246-9.
DOI: https://doi.org/10.1016/j.jclinane.2009.07.010
Álvarez-Díaz N, Amador-García I, Fuentes-Hernández M, Dorta-Guerra R. Comparison between transthoracic lung ultrasound and a clinical method in confirming the position of double-lumen tube in thoracic anaesthesia. A pilot study. Rev Esp Anestesiol Reanim 2015;62:305-12.
DOI: https://doi.org/10.1016/j.redare.2014.06.001
Saporito A, Lo Piccolo A, Franceschini D, et al. Thoracic ultrasound confirmation of correct lung exclusion before one-lung ventilation during thoracic surgery. J Ultrasound 2013;16:195-9.
DOI: https://doi.org/10.1007/s40477-013-0050-9
Ethics Approval
The study protocol was approved by Institutional Human Ethics Committee of All India Institute of Medical Sciences, Bhopal, IndiaHow to Cite
Gupta, Ekta, Pooja Singh, Sunaina Tejpal Karna, Yogesh Niwariya, Vaishali Waindeskar, Sourabh Jain, Rajesh Panda, and Sandeep Kumar. 2023. “Comparison of Lung Ultrasound Technique <em>versus< em> Clinical Method to Evaluate the Accuracy of Size and Placement of Left Endobronchial Double Lumen Tube in Patients Undergoing Elective Thoracic Surgery: A Prospective Observational Study”. Monaldi Archives for Chest Disease, September. https://doi.org/10.4081/monaldi.2023.2700.
Copyright (c) 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Lorenzo Agostini, Nicola Facciolongo, Mirco Lusuardi, Eleonora Casalini, Carla Galeone, Luciano Lasagni, Luigi Zucchi, Endobronchial ultrasound-guided transbronchial needle aspiration under conscious sedation with meperidine and midazolam , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Dimitrios Papadopoulos, Panagiotis Misthos, Maria Chorti, Vlasios Skopas, Alexandra Nakou, Napoleon Karagianidis, Achilleas Lioulias, Vasiliki Filaditaki, Unilateral pulmonary hypoplasia in an adult patient , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
- Emanuela Barisione, Carlo Genova, Marco Grosso, Mercedes Pasquali, Alessandro Blanco, Raffaella Felletti, Mario Salio, Palliative treatment of life-threatening hemoptysis with silicone stent insertion in advanced lung cancer , Monaldi Archives for Chest Disease: Vol. 87 No. 1 (2017)
- F.G. Salerno, O. Resta, M.P. Foschino-Barbaro, A. Spanevello, The mechanics of the lung parenchyma and airway responsiveness to metacholine , Monaldi Archives for Chest Disease: Vol. 61 No. 4 (2004): Pulmonary series
- A. Brunelli, C. Pompili, M. Salati, Low-technology exercise test in the preoperative evaluation of lung resection candidates , Monaldi Archives for Chest Disease: Vol. 73 No. 2 (2010): Pulmonary series
- Andrea Imperatori, Maria Cattoni, Luca Bertolaccini, Mario Nosotti, Lorenzo Rosso, Lucio Cagini, Jacopo Vannucci, Alessandro Brunelli, Roberto Crisci, Carlo Curcio, Nicola Rotolo, Assessment of the 90-day mortality risk score after video-assisted thoracoscopic lobectomy in the Italian VATS Group cohort , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- E. Nardecchia, L. Perfetti, M. Castiglioni, D. Di Natale, A. Imperatori, N. Rotolo, Bullous lung disease and neurofibromatosis type-1 , Monaldi Archives for Chest Disease: Vol. 77 No. 2 (2012): Pulmonary series
- G.F. Tassi, G.P. Marchetti, V. Pinelli, S. Chiari, Practical management of pleural empyema , Monaldi Archives for Chest Disease: Vol. 73 No. 3 (2010): Pulmonary series
- O. Toungoussova, M.P. Foschino Barbaro, L.M. Esposito, G.E. Carpagnano, F.G. Salerno, R.W. Dal Negro, A. Spanevello, Brittle asthma , Monaldi Archives for Chest Disease: Vol. 67 No. 2 (2007): Pulmonary series
- Christopher Ull, Mirko Aach, Josef Reichert, Thomas Armin Schildhauer, Justyna Swol, Successful non-surgical management of pleuroparenchymal fistula following cervical intraspinal empyema , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
<< < 1 2 3 4 5 6 7 8 9 10 > >>
You may also start an advanced similarity search for this article.
