Ultrasound vs. Auscultation and Fiberoptic Bronchoscopy for Double-Lumen Tube Placement

March 6, 2026 updated by: Derya Arslan Yurtlu, Izmir City Hospital

Ultrasonographic Confirmation of Double-Lumen Endobronchial Tube Placement Compared With Auscultation and Fiberoptic Bronchoscopy in Thoracic Surgery: A Prospective Observational Study

One-lung ventilation is frequently required in thoracic surgery and is most commonly achieved using double-lumen endobronchial tubes (DLTs). Correct positioning of the DLT is crucial for effective lung isolation and patient safety. Fiberoptic bronchoscopy (FOB) is considered the gold standard for confirming DLT placement; however, it may not always be immediately available and requires specific expertise.

Lung ultrasonography is a rapid, noninvasive, and bedside imaging method increasingly used in anesthesiology and critical care. This prospective observational study aims to evaluate the diagnostic performance of lung ultrasound in confirming the correct position of double-lumen endobronchial tubes in patients undergoing thoracic surgery.

The results obtained from lung ultrasound will be compared with auscultation findings and fiberoptic bronchoscopy results. Fiberoptic bronchoscopy will be considered the reference standard. The sensitivity, specificity, positive predictive value, and negative predictive value of lung ultrasound and auscultation will be calculated.

Study Overview

Status

Recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Adult patients aged 18-65 years undergoing elective thoracic surgery requiring one-lung ventilation with a double-lumen endobronchial tube at Izmir City Hospital will be included in this study. Patients will be recruited consecutively after providing written informed consent. The position of the double-lumen tube will be evaluated using auscultation and lung ultrasonography and confirmed by fiberoptic bronchoscopy as part of routine clinical practice.

Description

Inclusion Criteria:

  • Age between 18 and 65 years
  • Scheduled for elective thoracic surgery
  • Planned one-lung ventilation
  • Use of double-lumen endobronchial tube
  • ASA physical status I-III
  • Written informed consent obtained

Exclusion Criteria:

  • Known airway anomalies
  • Previous lung resection surgery
  • Tracheostomy
  • Coagulopathy
  • Pleural effusion or pleural pathology that may interfere with lung ultrasound evaluation
  • Chest wall deformity
  • Emergency surgery
  • Patients who decline participation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Thoracic surgery patients undergoing one-lung ventilation with double-lumen tube
Adult patients undergoing elective thoracic surgery requiring one-lung ventilation with a double-lumen endobronchial tube. Tube position will be evaluated using auscultation and lung ultrasound, and confirmed by fiberoptic bronchoscopy as the reference standard.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Diagnostic accuracy of lung ultrasound for confirmation of double-lumen tube placement
Time Frame: Intraoperative (immediately after DLT placement)
Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy of lung ultrasound in confirming correct double-lumen endobronchial tube placement compared with fiberoptic bronchoscopy as the reference standard.
Intraoperative (immediately after DLT placement)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Agreement between methods
Time Frame: Intraoperative
Agreement between lung ultrasound, auscultation, and fiberoptic bronchoscopy in confirming DLT position will be evaluated using Cohen's kappa coefficient.
Intraoperative
Diagnostic accuracy of auscultation for confirmation of double-lumen tube placement
Time Frame: Intraoperative
Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of auscultation for confirming correct double-lumen tube placement compared with fiberoptic bronchoscopy.
Intraoperative
Time required to confirm correct double-lumen tube placement
Time Frame: Immediately after tube placement
Time required to confirm correct double-lumen endobronchial tube position using lung ultrasound, auscultation and fiberoptic bronchoskopy.
Immediately after tube placement
Effect of right- versus left-sided double-lumen endobronchial tubes on diagnostic performance
Time Frame: ıntraoperative (immediately after DLT placement)
Comparison of the diagnostic performance of lung ultrasound and auscultation for confirming correct double-lumen endobronchial tube position in right-sided versus left-sided double-lumen tubes, using fiberoptic bronchoscopy as the reference standard. Measures will include sensitivity, specificity, PPV, NPV, and overall accuracy within each DLT type.
ıntraoperative (immediately after DLT placement)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Izmir City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 25, 2026

Primary Completion (Estimated)

May 25, 2026

Study Completion (Estimated)

June 15, 2026

Study Registration Dates

First Submitted

March 6, 2026

First Submitted That Met QC Criteria

March 6, 2026

First Posted (Actual)

March 12, 2026

Study Record Updates

Last Update Posted (Actual)

March 12, 2026

Last Update Submitted That Met QC Criteria

March 6, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • İŞH- AD

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

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