Ultrasound for Double Lumen Endotracheal Tube

Study Overview
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Brief Summary
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The patients will be allocated to 2 groups: the ultrasound group and the clinical group. The correct position of the double lumen tube will be determined by ultrasound (Sonoscape S6®) for the patients of the one group (group U) and by clinical examination for the patients of the other group (group C). The correct placement will be verified by bronchoscopy (Pentax®). The two methods will be compared in terms of sensitivity and specificity. The main purpose of the study is to determine if the ultrasound can be used for determination of the correct placement of the left sided double lumen endotracheal tube

Official Title
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Comparison Between Ultrasound and Clinical Assessment of the Correct Positioning of Left Double Lumen Endotracheal Tube

Conditions
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Lung Ultrasound

Intervention / Treatment
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* Device: Determination of tube position by ultrasound.
* Other: Determination of tube position by auscultation.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Surgery requiring placement of double-lumen endotracheal tube. ASA 1-3 Exclusion Criteria: History of difficult or impossible intubation. Clinical findings of possible difficult intubation according to the standard preoperative airway assessment. Impossible placement of a double lumen tube

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ultrasound<br>Determination of correct placement of the double lumen tube by lung ultrasound. | Device: Determination of tube position by ultrasound.<br>* After placement of the left sided double lumen endotracheal tube, ventilation of both lungs will be verified by ultrasound (Sonoscape S6®). The ultrasound probe will be placed between the 2nd and 3rd intercostal space at the level of the midclavicular line parallel to the line. The probe will be slightly moved or tilted until the pleural line is identified. If lung sliding is identified then the ventilation of the lung will be considered adequate. The same procedure will be repeated for each lung alone, after lung separation is applied. Verification of the ultrasound findings will be performed by bronchoscopy (Pentax®). The depth of the tube will be adjusted according to the bronchoscopy findings until correct positioning is established.<br>|
| Active Comparator: Clinical<br>Determination of correct placement of the double lumen tube by clinical examination. | Other: Determination of tube position by auscultation.<br>* After placement of the left sided double lumen endotracheal tube, ventilation of both lungs will be verified by auscultation of the upper lung fields. The same procedure will be repeated for each lung alone, after lung separation is applied. Verification of the ultrasound findings will be performed by bronchoscopy (Pentax®). The depth of the tube will be adjusted according to the bronchoscopy findings until correct positioning is established.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correct position of the tube (yes/no). | The anesthesiologist who will place the left-sided double lumen tube will determine if the position of the tube is correct according to the ultrasound or clinical findings. | Within an average of 5 minutes after the placement of the double lumen tube | 
| Correct position of the tube by bronchoscopy (yes/no). | After the assessment of the tube's position, a second anesthesiologist will verify the position of the tube by bronchoscopy. | Within an average of 10 minutes after the placement of the double lumen tube. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time needed | The total time passed from the beginning of laryngoscopy until the final verification of the tube's position. | Within an average of 10 minutes after the placement of the double lumen tube. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ultrasound, Double lumen tube