Comparison of displacement of polyvinyl chloride and silicone leftsided double-lumen tubes during lateral positioning

• Published in: Korean journal of anesthesiology Vol. 72; no. 1; pp. 32 - 38
• Main Authors: Kwon, Nyeong Keon, Jung, Sung Mee, Park, Sang-Jin, Han, Yonghee
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한마취통증의학회 01.02.2019
• Subjects: Adult; Aged; Female; Humans; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - instrumentation; Male; Middle Aged; One-Lung Ventilation - instrumentation; Patient Positioning; Polyvinyl Chloride; Prospective Studies; Silicones; Single-Blind Method; Thoracic Surgical Procedures - instrumentation; 마취과학; Bronchoscopy; One-lung ventilation; Displacement; Intratracheal intubation; Posture; Thoracic surgical procedure
• ISSN: 2005-6419; 2005-7563; 2005-7563
• DOI: 10.4097/kja.d.18.00012

Compared to an equivalent sized polyvinyl chloride (PVC) double-lumen tube (DLT), a silicone DLT has a shorter endobronchial segment. The aim of this study was to compare the incidence of clinically significant displacement of left-sided PVC and silicone DLTs after a positional change to a lateral position from a supine position and determine its effect on the need for DLT repositioning for successful lung separation in patients undergoing thoracic surgery. One hundred eight adult patients requiring one-lung ventilation were randomly divided into group P (PVC DLT, n = 54) and group S (Silicone DLT, n = 54). The position of the DLT was observed before and after lateral positioning to assess the effect of the position change. The incidence of clinically significant displacement (> 10 mm) of DLT was compared between the groups. DLTs were clinically significantly displaced in group P (17/48, 35.4%) and group S (18/52, 34.6%) after lateral positioning (P = 0.933). A proximal displacement (31.3% [group P] and 25.0% [group S]) was more common than distal displacement (4.2% [group P] and 9.6% [group S]), with no significant intergroup difference (P = 0.494). After lateral positioning, critical malposition of DLT with bronchial herniation to the right main bronchus was 8.3% (group P) and 7.9% (group S, P = 0.906). Left-sided PVC and silicone DLTs produced comparable incidences of clinically significant displacement and, consequently, required similar rates of repositioning for successful lung separation after lateral positioning.