Disconnection Technique With a Bronchial Blocker for Improving Lung Deflation
- Conditions
- Pneumothorax
- Interventions
- Procedure: DLT with conventional techniqueProcedure: Disconnection techniqueProcedure: BB with conventional technique
- Registration Number
- NCT01846936
- Lead Sponsor
- Ajou University School of Medicine
- Brief Summary
One lung ventilation (OLV) is accomplished with a double lumen tube (DLT) or a bronchial blocker (BB). In this study, the investigators compared the effectiveness of lung collapse using DLT, BB with spontaneous collapse, and BB with disconnection technique.
- Detailed Description
In selecting this maneuver of OLV, lung collapse is a major concern because it permits adequate surgical exposure. Although once lung deflation was achieved, the overall clinical performance appears to be similar, BB takes longer to deflate the operative lung and there is some conflict reports as to BB provides a similar degree of lung deflation compared to that of DLT.
The aim of this study was to compare the efficacy of BB and DLT for achieving lung collapse, and to evaluate the efficacy of disconnection technique with monitoring the carbon dioxide trace on a capnograph in BB. The investigators further evaluated the disconnection time, which is the time to loss of carbon dioxide trace on the capnograph, needed to facilitate lung collapse.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 54
- Patients undergoing thoracic surgery for which OLV is required
- Patients with an anticipated difficult intubation with infectious or bleeding lung lesions are excluded.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description DLT with conventional technique DLT with conventional technique The double lumen tube is introduced into the glottis under direct laryngoscopy. After the bronchial cuff had passes the vocal cords, the tube is rotated counterclockwise 90° and advanced until a slight resistance was encountered. One lung ventilation is initiated after the lumen of operative lung is clamped and opened. Disconnection technique Disconnection technique Disconnection technique; 1) before initiating OLV, we turned-off the ventilator and fully opened the adjustable pressure limiting valve allowing both lungs to collapse, and 2) after loss of the carbon dioxide trace on the capnograph, 3) inflated the BB cuff with air, and 4) turned-on the ventilator allowing only dependent-lung reventilation. BB with conventional technique BB with conventional technique The brochial blocker (BB) is introduced through the endotracheal tube to the desired bronchus under fiberoptic bronchoscopy (FOB) vision by turning the device's steering wheel. The BB cuff is inflated with air under FOB vision with the volume necessary to seal the bronchus and initiate one lung ventilation. And then, dependent lung is ventilated.
- Primary Outcome Measures
Name Time Method Effectiveness of three lung isolation methods Ten min from the start of one lung ventilation The degree of lung collapse after 5 min from the start of OLV. The degree of lung collapse was assessed using a lung collapse score (0 = no collapse, to 10 = complete collapse) by one thoracic surgeon. The surgeon who assessed the lung collapse was absent from the operating room during DLT or BB placement and was blinded to the airway device.
- Secondary Outcome Measures
Name Time Method The disconnection time The time to loss the carbon dioxide trace on the capnograph (30 seconds) Before initiating OLV in group 3, we turned-off the ventilator and fully opened the adjustable pressure limiting valve allowing both lungs to collapse. And then, the time which capnograph lose the carbon dioxide curve is considered the disconnection time required for both lungs to collapse before initiating one lung ventilation.
Trial Locations
- Locations (1)
Ajou University Hospital
🇰🇷Suwon, Gyung Gi, Korea, Republic of