An intubation method for mono-pulmonary ventilation in patients with difficult airway

This study aimed to compare the clinical effect between thermal softening PVC double-lumen tube (DLT) and single-lumen tube (SLT) guided by laryngoscope and bronchoscopy in patients with difficult airways.

72 patients with chest surgery in need of mono-pulmonary ventilation, aged 20-70 years old, with ASA rating I-III and Arné scoring ≥ 11, were enrolled. Patients were categorized randomly into two groups with 36 patients in each: the D group (DLT was used) and the S group (SLT was used). Bronchoscopy was used for guiding the intubation and aligning in both groups. Laryngoscope would also be used immediately after failure in two trials of intubation. Intubation resistance, intubation success rate, laryngoscopy assist rate, time for intubation, time for alignment, incidence of catheter dislocation, VAS score for post-operative throat pain, and the damage extent of vocal cord were recorded.

No significant differences were seen between two the groups in terms of intubation resistance, intubation success rate, laryngoscopy assist rate, time for intubation, VAS score for post-operative throat pain, and the damage extent of vocal cord. However, shorter time for alignment and lower incidence of catheter dislocation were observed in the D group than in the S group (both p < 0.05).

For intubation in patients with difficult airway, the thermal softening DLT was as safe as the SLT, but simpler in alignment and had a lower dislocation incidence. Meanwhile, video laryngoscope could increase the success rate of intubation with either tube.