New Technique to Assess Correct Positioning of the Right-sided Double Lumen Tube
A New Technique to Assess the Correct Positioning of a Right-sided Double-lumen Tube Without Fiberoptic Bronchoscopy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Right-sided double lumen tube (Mallinckrodt - Endobronchial tube) is introduced into the glottis via direct laryngoscopy. After the endotracheal lumen tube has passed the vocal cords, the stylet is removed, and the tube is rotated 90° toward the right and advanced slightly until resistance is encountered. Auscultation is then performed to check the proper side the endobronchial tube was inserted to.
Then, the anatomy of the carina and the origins of the right and left upper bronchus are identified with the video-bronchoscopy.
After a mild plication of the distal extremity of an adult central venous catheter wire guide (0.53mm diameter, 45cm length, one straight soft tip on one end and one "J" tip on other), the J-shaped extremity of this guide is introduced through the endobronchial lumen under direct video-bronchoscope. The wire guide is then slowly removed in order that proper alignment between the wire extremity and the right upper lobe occurs. The wire is removed again until its J-shaped extremity appears through the right-upper lobe ventilation orifice. In order to align the orifice of the tube with the upper lobe bronchus, a rotational movement of the double-lumen tube may be necessary. When the location of the orifice of the right upper lobe is identified, the guide is moved forward through the orifice into the upper lobe bronchus.
Once satisfactory initial placement is achieved, the bronchial cuff is left inflated, the wire guide of the central venous catheter is kept in place in the upper lobe bronchus, and the patient is turned to the right lateral decubitus position. The proper positioning of the tube is once again checked by another video-bronchoscopy.
To confirm the exact placement of the tube, a fiberoptic bronchoscopy is performed through the endobronchial lumen to find the right upper lobe ventilation orifice and confirm alignment. Then, it is placed distally to the endobronchial lumen to confirm a clear view showing the bronchus intermedius.
After passing the fiberoptic bronchoscope through the tracheal lumen, the blue bronchial cuff is visualized at the origin of the right main stem bronchus below the level of the carina.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Brussels, Belgium, 1200
- Cliniques Universitaires Saint-luc
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- all patients > 18 years old who have to undergo a left thoracic surgery with a one lung ventilation technique
Exclusion Criteria:
- emergency surgical procedures, patients with predictable difficulties of insertion of a double-lumen endotracheal tube, hemodynamically unstable patients
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Device Feasibility
- Allocation: Non-Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Positioning of right-sided double lumen tube with fluoroscopy
positioning of the right-sided double lumen tube with a wire guide and fluoroscopy
|
Verification of a new technique to assess the correct positioning of a right-sided double-lumen tube for left thoracic surgeries, using a central venous catheter wire guide and a radioscopy
Other Names:
|
|
Experimental: Positioning of right-sided double lumen tube with fibroscope
positioning of the right sided double lumen tube in the same patient but with a fibroscope
|
Verification of a new technique to assess the correct positioning of a right-sided double-lumen tube for left thoracic surgeries, using a central venous catheter wire guide and a radioscopy
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Measurement of the distance between the lateral orifice of the tube and the orifice of the right upper lobe bronchus
Time Frame: 20 minutes
|
Fibroscopic measurement to assess the correct positioning of the right-sided double lumen tube with the wire guide and the fluoroscopy
|
20 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Total time spent to correctly position the right-sided double lumen tube
Time Frame: 20 minutes
|
If the technique with the wire guide and the fluoroscopy, takes more than 20 minutes to be achieved, it is considered as failed.
|
20 minutes
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Christine Watremez, MD, PhD, Cliniques Universitaires Saint-luc
Publications and helpful links
General Publications
- Campos JH, Massa FC, Kernstine KH. The incidence of right upper-lobe collapse when comparing a right-sided double-lumen tube versus a modified left double-lumen tube for left-sided thoracic surgery. Anesth Analg. 2000 Mar;90(3):535-40. doi: 10.1097/00000539-200003000-00007.
- de Bellis M, Accardo R, Di Maio M, La Manna C, Rossi GB, Pace MC, Romano V, Rocco G. Is flexible bronchoscopy necessary to confirm the position of double-lumen tubes before thoracic surgery? Eur J Cardiothorac Surg. 2011 Oct;40(4):912-6. doi: 10.1016/j.ejcts.2011.01.070. Epub 2011 Jul 29. Erratum In: Eur J Cardiothorac Surg. 2012 Jun;41(6):1411. Lamanna, Carmine [corrected to La Manna, Carmine].
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2016/29dec/565
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Anesthesia
-
NCT06076096CompletedAnesthesia | Regional Anesthesia | Anesthesia Management
-
NCT03383770CompletedAnesthesia, Local | Anesthesia | Anesthesia; Adverse Effect
-
NCT03833947CompletedAnesthesia | Anesthesia Intubation Complication | Anesthesia; Adverse Effect
-
NCT01474382CompletedAnesthesia, Local | Dental Anesthesia | Anesthesia, Reversal
-
NCT05834647Not yet recruitingAnesthesia | Anesthesia; Reaction
-
NCT03786211UnknownAnesthesia | Anesthesia; Functional
-
NCT06866886CompletedAnesthesia | Sedation | Anesthesia, Intravenous | Sedation Complication | Recovery From Anesthesia | Monitoring of Depth of Anesthesia
-
NCT07103616Not yet recruitingAnesthesia | Anesthesia; Reaction
Clinical Trials on right-sided double lumen tube
-
NCT02919267CompletedThoracic Surgery | One-Lung Ventilation | Lung Collapse | Video-Assisted
-
NCT03392922CompletedTherapeutic Procedural Complication
-
NCT07373171Not yet recruitingLung Adenocarcinoma | Lung Abscess
-
NCT01807676CompletedPatients Undergoing Elective Thoracic Surgery Requiring Obligatory Single-lung Ventilation During Surgery
-
NCT07362797Not yet recruitingThoracoscopic Surgery | Double Lumen Tube Intubation
-
NCT03690284CompletedSingle Lung Ventilation | Double Lumen Endotracheal Tube
-
NCT04101734CompletedPredictive Value of Tests | Intubation;Difficult
-
NCT03624439CompletedIntubation; Difficult or Failed | Difficult Airway | Intubation;Difficult
-
NCT02253979CompletedEndotracheal Intubation | Airway Management | One Lung Ventilation