Korean J Anesthesiol.  2019 Feb;72(1):32-38. 10.4097/kja.d.18.00012.

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

• Kwon NK
• Jung SM
• Park SJ
• Han Y

• KMID: 2438619
• DOI: http://doi.org/10.4097/kja.d.18.00012

Abstract

BACKGROUND
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.
METHODS
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.
RESULTS
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).
CONCLUSION
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.

Keyword

Bronchoscopy; Displacement; Intratracheal intubation; One-lung ventilation; Posture; Thoracic surgical procedure

MeSH Terms

Adult
Bronchi
Bronchoscopy
Humans
Incidence
Intubation, Intratracheal
Lung
One-Lung Ventilation
Polyvinyl Chloride*
Polyvinyls*
Posture
Silicon*
Silicones*
Supine Position
Thoracic Surgery
Thoracic Surgical Procedures
Polyvinyl Chloride
Polyvinyls
Silicon
Silicones