title: A retrospective evaluation of the use of video-capable double-lumen endotracheal tubes in thoracic surgery.
abstract: OBJECTIVE
  The objective of this study was to evaluate whether the use of a video double-lumen tube reduced the need for fiberoptic bronchoscopy for (1) verification of initial tube placement and for (2) reverification of correct placement after repositioning for thoracotomy.
  
  
  METHODS
  A single-center retrospective study.
  
  
  METHODS
  Thoracic surgery in a medical university hospital.
  After institutional review board approval, 29 patients who underwent thoracic surgical procedures using video double-lumen tubes were included in the final retrospective analysis.
  
  
  RESULTS
  For 27 (93.2%) patients, the use of fiberoptic bronchoscopy was not needed either for initial placement or for verification of correct video double-lumen tube placement upon final positioning of the patient. However, for two patients, fiberoptic bronchoscopy was needed: for (1) one patient with severe left mainstem bronchus distortion as a result of a large left upper lobe tumor, and (2) a second patient with secretions that were difficult to clear.
  
  
  CONCLUSIONS
  This study demonstrates that the video double-lumen tube requires significantly less (6.8%) fiberoptic use for both initial placement and verification of final position, in stark contrast to standard practice in which bronchoscopy is always used to verify final positioning of the double-lumen tube. As opposed to intermittent bronchoscopy, the continuous visualization offered by an embedded camera may confer an added measure of safety.
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: jsheir@mdanderson.org.
authors.forename: Jagtar Singh
authors.initials: JS
authors.lastname: Heir
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Ron
authors.initials: R
authors.lastname: Purugganan
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Jackson
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Norman
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Alyssa
authors.initials: A
authors.lastname: Kosturakis
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Dilip
authors.initials: D
authors.lastname: Thakar
mesh_terms: D000368:Aged; D001999:Bronchoscopy / Q000379:methods; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods*; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures; D014741:Video Recording / Q000295:instrumentation*
keywords: double-lumen tubes; fiberoptic bronchoscopy; fiberoptics; one-lung ventilation; thoracic anesthesia; thoracic surgery; video-double-lumen endobronchial tube