title: Efficiency, efficacy, and safety of EZ-blocker compared with left-sided double-lumen tube for one-lung ventilation.
abstract: BACKGROUND
  Double-lumen tubes (DLTs) or bronchial blockers are commonly used for one-lung ventilation. DLTs are sometimes difficult or even impossible to introduce, and the incidence of postoperative hoarseness and airway injuries is higher. Bronchial blockers are more difficult to position and need more frequent intraoperative repositioning. The design of a Y-shaped bronchial blocker, the EZ-Blocker (Teleflex Life Sciences Ltd., Athlone, Ireland) (EZB), combines some advantages of both techniques. The objective of this study was to assess whether EZB performs clinically better than left-sided DLTs (Broncho-cath; Mallinckrodt, Athlone, Ireland) without causing more injury. Primary outcome was the frequency of initial malpositions.
  
  
  METHODS
  Eligible patients were adults scheduled for surgery requiring one-lung ventilation who met criteria for placement of both devices. In this parallel trial, 100 consecutive and blinded patients were assigned randomly using a computer-generated list to two groups. The incidence of malposition and ease and time of placement were recorded. Blinded assessors investigated quality of lung deflation, postoperative complaints, and damage to the airway.
  
  
  RESULTS
  Placement of a DLT was unsuccessful twice. The incidence of initial malposition was high and comparable between EZBs (37 of 50) and DLTs (42 of 49) (P = 0.212). Placing single-lumen tubes and EZBs took more time but was rated easier. Quality of lung deflation was comparable. Fewer patients in the EZB group complained of sore throat at day 1. There was a higher incidence of tracheal hematoma and redness and bronchial hematoma in the DLT group.
  
  
  CONCLUSIONS
  The EZB is an efficient and effective device for one-lung ventilation and causes less injury and sore throat than a DLT.
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. j.mourisse@anes.umcn.nl
authors.forename: Jo
authors.initials: J
authors.lastname: Mourisse
authors.forename: Jordi
authors.initials: J
authors.lastname: Liesveld
authors.forename: Ad
authors.initials: A
authors.lastname: Verhagen
authors.forename: Garance
authors.initials: G
authors.lastname: van Rooij
authors.forename: Stefan
authors.initials: S
authors.lastname: van der Heide
authors.forename: Olga
authors.initials: O
authors.lastname: Schuurbiers-Siebers
authors.forename: Erik
authors.initials: E
authors.lastname: Van der Heijden
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000009:adverse effects* / Q000295:instrumentation*; D004311:Double-Blind Method; D004867:Equipment Design / Q000295:instrumentation; D005260:Female; D006685:Hoarseness / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D061810:One-Lung Ventilation / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D010612:Pharyngitis / Q000453:epidemiology* / Q000517:prevention & control; D012121:Respiration, Artificial / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome