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

Early Access
Submitted: July 5, 2023
Accepted: September 5, 2023
Published: September 18, 2023
Thoracic anesthesia, airway management, endobronchial double lumen tube, tracheal ultrasonography, lung ultrasound, anthropometric measurement, lung isolation
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Authors

Ekta Gupta
https://orcid.org/0000-0003-1985-9838
Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Pooja Singh
docanesthesia@gmail.com
https://orcid.org/0000-0003-0556-7359
Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Sunaina Tejpal Karna
https://orcid.org/0000-0002-4200-5948
Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Yogesh Niwariya
https://orcid.org/0000-0001-6699-1984
Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Vaishali Waindeskar
Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Sourabh Jain
Department of Critical Care, Apollo-Sage Hospital, Bhopal, Madhya Pradesh, India.
Rajesh Panda
https://orcid.org/0000-0001-7123-876X
Department of Critical Care, Kalinga Institute of Medical Sciences, Bhubaneswar, Orissa, India.
Sandeep Kumar
https://orcid.org/0000-0001-7641-8807
Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

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.

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Ethics Approval

The study protocol was approved by Institutional Human Ethics Committee of All India Institute of Medical Sciences, Bhopal, India
Yogesh Niwariya, Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh

 

 

How 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.
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