Impact of Patient Position on the Success in Placing Triple-cuffed Double Lumen Endotracheal Tube

Study Overview
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Brief Summary
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Triple-cuffed double lumen endotracheal tube (TC-DLT, ANKOR tube. Insung corp., Korea) which was developed to isolate lung without endotracheal bronchoscope guidance has additional carinal cuff placed between bronchial tube cuff and tracheal tube cuff. This device has been successfully used to isolate lung more simply in specific settings when there is too much excretion to visualize endotracheal structure or for a health provider who is not good at use of traditional double-lumen tube. Although TC-DLT is designed to enable lung separation effectively in situations that confirmation of tube position using bronchoscopy is difficult or not available, but no studies have been conducted on whether effective lung isolation using TC-DLT is possible after change in the relative position of the bronchial tree by postural change. This plan was prepared for research on this.

Detailed Description
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After enter into operating room, induction of anesthesia is performed through standard general anesthesia procedure before endotracheal intubation. Endotracheal intubation is performed using TC-DLT and inflate carinal cuff with 5   15ml of air. Then, push it into trachea until resistance is felt. When carinal cuff is placed at carina, deflate carinal cuff and isolate independent lung followed by confirmation of bronchial cuff position using fiberoptic bronchoscopy. Record the location of the bronchial balloon in one of the following conditions at proper position(proximal upper end of bronchial balloon is between 5mm from carinal opening) : proximal end of bronchial balloon is placed more of 5mm distally from carinal opening proximal end of bronchial balloon is placed more of 5mm proximally from carinal opening Then, change patient position to left lateral decubitus (LLD) position and check the position of bronchial balloon using fiberoptic bronchoscopy as previously done. at proper position(proximal upper end of bronchial balloon is between 5mm from carinal opening) : proximal end of bronchial balloon is placed more of 5mm distally from carinal opening proximal end of bronchial balloon is placed more of 5mm proximally from carinal opening After check whether there is something to considerate, end this case.

Official Title
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Impact of Patient Position on the Success in Placing Triple-cuffed Double Lumen Endotracheal Tube : Multi-center Observational Study

Conditions
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Lung Diseases

Intervention / Treatment
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* Device: Intubation using 3-cuffed double lumen endotracheal tube


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults who is including in ASA class I or II Patients scheduled for right lung surgery under right lung isolation Patients who don't have any anatomical variations in pulmonary system Patients who have never gotten a lung surgery Exclusion Criteria: Pregnancy Patients who are predicted difficult intubation Patients who is under upper airway infection Patients who have coagulopathy Emergency surgery In addition, patients considered inappropriate to participate in this study

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Interventional Model Description: Interventional observational study. The investigators conduct this study to analyze the impact of patient position on the success in placing triple-cuffed double lumen endotracheal tube.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Test group<br>There is only one group to evaluate this observational study. | Device: Intubation using 3-cuffed double lumen endotracheal tube<br>* After patient's position, 3-cuffed double lumen endotracheal tube is intubated without fiberoptic bronchoscopy guidance<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success rate of 3-cuffed double lumen tube inserted in lateral position | Authors insert 3-cuffed double lumen tube after position change to left lateral decubitus with blind fashion. At this time, probability that the tube will be inserted to an appropriate depth is primary endpoint. | During procedure(Immediately after secondary intubation) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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3-cuffed double lumen tube, one lung ventilation, lung isolation