Modified right-sided Broncho-Cath double lumen tube improves endobronchial positioning: a randomized study

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Medical Device Engineering

Background:

• Right-sided double lumen tubes (R-DLTs) are essential for specific thoracic surgeries but are prone to malposition.
• Optimal positioning of R-DLTs is critical for effective one-lung ventilation.

Purpose of the Study:

• To evaluate the impact of a modified R-DLT with an enlarged lateral orifice on the adequacy of its positioning.
• To compare the modified R-DLT with the standard Mallinckrodt Broncho-Cath R-DLT.

Main Methods:

• Eighty patients undergoing elective thoracic surgery were randomized to receive either a standard or modified R-DLT.
• Fiberoptic bronchoscopy was used to assess R-DLT positioning in supine and lateral positions.
• A scoring system evaluated the position of the right upper lobe orifice relative to its origin.

Main Results:

• The modified R-DLT achieved adequate positioning more frequently (77% vs. 37%) immediately after patient repositioning (T2).
• Repositioning the modified R-DLT was easier and more successful (97% vs. 74%) in the lateral position (T3).

Conclusions:

• The modified Broncho-Cath R-DLT demonstrates superior performance in achieving and maintaining optimal positioning.
• This modification facilitates more effective one-lung ventilation during thoracic procedures.