Lung isolation during port-access cardiac surgery: double-lumen endotracheal tube versus single-lumen endotracheal tube with a bronchial blocker.
OBJECTIVE
The purpose of this study was to compare the use of a double-lumen endotracheal tube to a single-lumen tube combined with a bronchial blocker for lung isolation during Port-Access cardiac surgery.


METHODS
Prospective, randomized, controlled trial.


METHODS
Tertiary care university hospital.


METHODS
Thirty-two patients undergoing Port-Access cardiac surgery via a right minithoracotomy.


METHODS
Patients were randomized to intubation with either a left-sided double-lumen tube (double-lumen group) or a single-lumen tube with concomitant use of a bronchial blocker (blocker group). Comparisons between groups included (1) intubation time, (2) number of laryngoscopy attempts, (3) time required for tube exchange at the end of the operation, and (4) surgical satisfaction with the lung deflation (1-5 scale: 5 = excellent).


RESULTS
The initial intubation time was similar between groups (118 +/- 82 seconds, double-lumen v 144 +/- 32 seconds, blocker; p = 0.2781). An additional 105 +/- 37 seconds was needed to exchange the double-lumen tube at the end of the operation. The double-lumen group also required more laryngoscopy attempts compared with the blocker group (2.3 +/- 0.6, double-lumen v 1.1 +/- 0.4, blocker; p = 0.0001). The lung deflation was better in the double-lumen group (5 [4-5], double-lumen v 4 [3-5], blocker, p = 0.0414).


CONCLUSIONS
Compared with a single-lumen tube/bronchial blocker combination the double-lumen endotracheal tube required more laryngoscopy attempts and additional time to replace the tube at the end of the case but resulted in slightly better overall lung deflation.
Grocott
Hilary P
HP
Department of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC 27710, USA. h.grocott@duke.edu
Darrow
Tanya R
TR
Whiteheart
Debra L
DL
Glower
Donald D
DD
Smith
Mark Stafford
MS
D001980:Bronchi / Q000502:physiology; D006348:Cardiac Surgical Procedures; D004867:Equipment Design; D004869:Equipment Safety / Q000706:statistics & numerical data; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods*; D008168:Lung / Q000502:physiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods*; D013997:Time Factors