Intubation with VivaSight or conventional left-sided double-lumen tubes: a randomized trial

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Medical Devices

Background:

• Double-lumen endotracheal tubes (DLTs) are crucial for single-lung ventilation in thoracic surgery but are challenging to insert and prone to displacement.
• Flexible bronchoscopy is the standard for confirming DLT placement, adding time and complexity to the procedure.
• The VivaSight DLT integrates a camera for continuous visualization, aiming to simplify and improve the intubation process.

Purpose of the Study:

• To evaluate if the novel VivaSight DLT, with its integrated camera, reduces intubation time compared to conventional DLTs.
• To assess secondary outcomes including insertion success, tube displacement, ease of use, lung collapse quality, and postoperative complications.

Main Methods:

• A randomized controlled trial involving 40 adult patients undergoing thoracic surgery.
• Patients were assigned to either the VivaSight DLT group (n=20) or the conventional DLT group (n=20).
• Primary outcome was time to successful intubation; secondary outcomes included insertion success, displacement, ease of insertion, lung collapse, and airway injuries.

Main Results:

• Mean time to intubation was significantly faster with the VivaSight DLT (63 sec) versus conventional DLT (97 sec; P=0.03).
• All VivaSight DLTs were inserted correctly, and malpositioning was easily corrected.
• Postoperative complaints were similar, but airway injuries were more frequent with VivaSight DLT, though the study was underpowered to confirm this.

Conclusions:

• The integrated camera of the VivaSight DLT enables faster insertion and simplifies initial and intraoperative positioning.
• The device aids in confirming correct tube placement and facilitates necessary repositioning during surgery.
• The VivaSight DLT offers a promising alternative for improving DLT insertion and management in thoracic procedures.