• Jagtar Singh Heir, Shu-Lin Guo, Ronaldo Purugganan, Tim A Jackson, Anupamjeet Kaur Sekhon, Kazim Mirza, Javier Lasala, Lei Feng, and Juan P Cata.
• Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: jsheir@mdanderson.org.
• J. Cardiothorac. Vasc. Anesth. 2018 Feb 1; 32 (1): 267-274.

ObjectiveTo compare the incidence of fiberoptic bronchoscope (FOB) use (1) during verification of initial placement and (2) for reconfirmation of correct placement following repositioning, when either a double-lumen tube (DLT) or video double-lumen tube (VDLT) was used for lung isolation during thoracic surgery.DesignA randomized controlled study.SettingSingle-center university teaching hospital.ParticipantsThe study comprised 80 patients who were 18 years or older requiring lung isolation for surgery.InterventionsAfter institutional review board approval, patients were randomized prior to surgery to either DLT or VDLT usage. Attending anesthesiologists placed the Mallinckrodt DLT or Vivasight (ET View Ltd, Misgav, Israel) VDLT with conventional laryngoscopy or video laryngoscopy then verified correct tube position through the view provided with either VDLT external monitor or FOB.Measurements And Main ResultsData collected included: sex, body mass index, successful intubation and endobronchial placement, intubation time, confirmation time of tube position, FOB use, quality of view, dislodgement of tube, and ability to forewarn dislodgement of endobronchial cuff and complications. FOB use for verification of final position of the tube (VDLT 13.2% [5/38] v DLT 100% [42/42], p < 0.0001), need for FOB to correct the dislodgement (VDLT 7.7% [1/13] v DLT 100% [14/14], p < 0.0001), dislodgement during positioning (VDLT 61.5% [8/13] v DLT 64.3% [9/14], p = ns), dislodgement during surgery (VDLT 38.5% [5/13] v DLT 21.4% [3/14], p = ns), and ability to forewarn dislodgement of endobronchial cuff (VDLT 18.4% [7/38] v DLT 4.8% [2/42], p = 0.078).ConclusionThis study demonstrated a reduction of 86.8% in FOB use, which was a similar reduction found in other published studies.Copyright © 2018 Elsevier Inc. All rights reserved.

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