title: Intubation with VivaSight or conventional left-sided double-lumen tubes: a randomized trial.
abstract: BACKGROUND
  Double-lumen endotracheal tubes (DLTs), which are commonly used for single-lung ventilation during surgery, are difficult to insert. In addition, they often move during surgical lung manipulation which can cause life-threatening complications. Flexible bronchoscopy is used routinely to establish and confirm proper DLT placement. The newly designed VivaSight DLT has an integrated camera, allowing continuous visualization of its position in the trachea. We hypothesized that the time to intubation using the VivaSight DLT would be faster than with a conventional DLT.
  
  
  METHODS
  We enrolled 40 adults scheduled for thoracic surgery. Patients were randomized to conventional DLT (n = 20) or VivaSight DLT (n = 20). Time to intubation was our primary outcome. Secondary outcomes were insertion success without flexible bronchoscopy, frequency of tube displacement, ease of insertion, quality of lung collapse, postoperative complaints, and airway injuries.
  
  
  RESULTS
  Time [mean (SD)] to successful intubation was significantly faster with the VivaSight DLT [63 (58) sec] compared with the conventional DLT [97 (84) sec; P = 0.03]. The VivaSight DLTs were correctly inserted during all attempts. When malpositioning of the VivaSight DLT occurred, it was easily remedied, even in the lateral position. The devices were comparable with respect to postoperative coughing, hoarseness, and sore throat. Airway injuries tended to be more common with the VivaSight DLT, although this study was underpowered for airway injuries.
  
  
  CONCLUSIONS
  The VivaSight DLT camera allowed faster insertion and facilitated initial positioning. It also confirmed proper tube positioning intraoperatively and facilitated repositioning when necessary. This trial was registered at clinicaltrials.gov: NCT01807676.
authors: Institute of Anesthesiology, University and University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
authors: Rolf
authors: R
authors: Schuepbach
authors: Bastian
authors: B
authors: Grande
authors: Giovanni
authors: G
authors: Camen
authors: Alexander R
authors: AR
authors: Schmidt
authors: Henrik
authors: H
authors: Fischer
authors: Daniel I
authors: DI
authors: Sessler
authors: Burkhardt
authors: B
authors: Seifert
authors: Donat R
authors: DR
authors: Spahn
authors: Kurt
authors: K
authors: Ruetzler
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061810:One-Lung Ventilation / Q000379:methods*; D012137:Respiratory System / Q000293:injuries; D019616:Thoracic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors