Efficiency, Efficacy, and Safety of EZ-Blocker Compared with Left-sided Double-lumen Tube for One-lung Ventilation
ABSTRACT BACKGROUND:: Double-lumen tubes (DLTs) or bronchial blockers are commonly used for one-lung ventilation. DLTs are sometimes difficult or even impossible to introduce, and the incidence of postoperative hoarseness and airway injuries is higher. Bronchial blockers are more difficult to position and need more frequent intraoperative repositioning. The design of a Y-shaped bronchial blocker, the EZ-Blocker (Teleflex Life Sciences Ltd., Athlone, Ireland) (EZB), combines some advantages of both techniques. The objective of this study was to assess whether EZB performs clinically better than left-sided DLTs (Broncho-cath; Mallinckrodt, Athlone, Ireland) without causing more injury. Primary outcome was the frequency of initial malpositions. METHODS:: Eligible patients were adults scheduled for surgery requiring one-lung ventilation who met criteria for placement of both devices. In this parallel trial, 100 consecutive and blinded patients were assigned randomly using a computer-generated list to two groups. The incidence of malposition and ease and time of placement were recorded. Blinded assessors investigated quality of lung deflation, postoperative complaints, and damage to the airway. RESULTS:: Placement of a DLT was unsuccessful twice. The incidence of initial malposition was high and comparable between EZBs (37 of 50) and DLTs (42 of 49) (P = 0.212). Placing single-lumen tubes and EZBs took more time but was rated easier. Quality of lung deflation was comparable. Fewer patients in the EZB group complained of sore throat at day 1. There was a higher incidence of tracheal hematoma and redness and bronchial hematoma in the DLT group. CONCLUSIONS:: The EZB is an efficient and effective device for one-lung ventilation and causes less injury and sore throat than a DLT.
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ABSTRACT: Over the past decades, indications for one lung ventilation (OLV) have largely increased in cardiothoracic, orthopedic and spinal surgery along with the advances in minimally invasive techniques. Lung isolation is currently achieved with a double-lumen endotracheal tube (DLT) or an endobronchial blocker (EBB). Expertises in videolaryngoscopy and fiberoptic bronchoscopy (FOB) are valuable assets for safe management of the upper airways and correct placement of DLTs and BBs. This review will focus on a rationale application of either of these lung isolation devices, discussing their specificities, indications and limitations which are relevant for thoracic and non-thoracic anesthesiologists.06/2014; DOI:10.1016/j.tacc.2014.04.003
Anesthesiology 10/2013; 119(4):990. DOI:10.1097/ALN.0b013e3182a44409 · 6.17 Impact Factor
Revista espanola de anestesiologia y reanimacion 01/2013; 61(1). DOI:10.1016/j.redar.2013.05.001