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

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). CONCLUSIONS: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.

SUBMITTER: Kwon NK

PROVIDER: S-EPMC6369336 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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

Kwon Nyeong Keon NK Jung Sung Mee SM Park Sang-Jin SJ Han Yonghee Y

Korean journal of anesthesiology 20180620 1

<h4>Background</h4>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.<h4>Methods</h4>One ...[more]

PMID: 29921088

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Project description:BackgroundAlthough there are at least seven manufacturers producing left-sided double-lumen tubes (DLTs), there have been few reports comparing the segments of these DLTs. In this study, we compared various segments of left-sided DLTs further.Materials and methodsWe examined five manufacturers' left-sided DLTs: Mallinckrodt, Portex, Rüsch, Sheridan, and Daiken-medical. We conducted the following six trials or measurements, and three supplemental trials or measurements: First, we tried to pass various sizes of steel balls down each lumen in order from the smallest (3 mm) to largest (4.5 mm). If the ball passed on the first attempt, we tried just once; otherwise, we made a second attempt. Second, we measured the external diameter of tracheal and bronchial cuff using a profile projector. Third, we measured the length of the cuff and tip of the bronchial segment of the tubes using the profile projector. Fourth, we measured various lengths of the tubes. Fifth, we measured the external diameter of both lumens and the tubules for tracheal and bronchial cuff inflation. Finally, we measured various cross-sectional areas including the tracheal lumen, bronchial lumen, and tubules for cuff inflation. We also conducted three supplemental studies. First, we measured air volume in the cuff when intracuff pressure equaled 2 or 3 kPa. Second, we defined the configuration of the tracheal and bronchial cuffs. Third, we defined the presence or absence of bevels and also measured the angle of the bevels using the profile projector.ResultsWe performed nine trials and measurements and found large disparities between each manufacturer's tubes.ConclusionsThe large disparities found between the measurements of the five manufacturers' tubes may be due to different lots or changes in specifications made by each manufacturer. We found tubes exhibiting lower quality, such as deformations, and non-universal and inconsistent sizing, in the comparison of the manufacturers' tubes. Practitioners should be aware of the features and aspects of these tubes.

Dataset Information

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

Publications

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

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