Lung Cancer, Pulmonary Nodule
Conditions
Keywords
First-attempt Intubation Success Rate, One-lung Ventilation, video double-lumen tube, secondary pulmonary resection
Brief summary
During thoracic surgery, double-lumen endotracheal intubation with one-lung ventilation is routinely performed to optimize surgical exposure, facilitate operative manipulation, and prevent iatrogenic lung injury. In patients undergoing repeat pulmonary surgery, prior lung resection may lead to pleural adhesions and tracheobronchial distortion, which substantially increase the difficulty of bronchial intubation. Even with experienced operators, the malposition rate of conventional double-lumen tubes remains high. The video double-lumen tube enables continuous visualization of the trachea and carina during insertion, positioning, and one-lung ventilation, allowing real-time airway monitoring. However, no clinical studies have specifically investigated airway management in patients undergoing redo pulmonary surgery. This study aimed to evaluate the efficacy and safety of the video double-lumen tube during anesthesia in patients undergoing secondary pulmonary resection.
Interventions
DEVICEVideo Double-Lumen Tube Group
Use the video double-lumen tube to perform left bronchial intubation under real-time visualization and continuously monitor its position.
DEVICEConventional Double-Lumen Tube Group
Insert a conventional left-sided double-lumen tube using standard intubation techniques.
Sponsors
Zhejiang University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years. * History of previous pulmonary resection. * Scheduled for elective pulmonary surgery. * Planned to receive a left-sided double-lumen tube. * ASA physical status I-III. * Patients have signed the informed consent form.
Exclusion criteria
* Preoperatively predicted difficult airway (Mallampati ≥ III, Cormack-Lehane ≥ III). * Acute respiratory distress syndrome (ARDS) or respiratory failure within the past 3 months. * Uncontrolled asthma. * Confirmed pregnancy or current breastfeeding. * Multiple traumatic injuries. * Current participation in another clinical trial. * Other conditions deemed unsuitable by the investigator.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Success rate of first-attempt bronchial intubation | During the first intubation attempt |
Secondary
| Measure | Time frame |
|---|---|
| Intubation time | Measured from insertion of the video laryngoscope into the mouth until confirmation of correct tube position |
| Requirement for and number of fiberoptic bronchoscopy uses | During the entire intraoperative period |
| Frequency of intraoperative tube repositioning | During the entire intraoperative period |
| Surgeon's rating of lung collapse quality | During the entire intraoperative period |
| Incidence of difficult intubation | At the time of intubation |
| Intubation-related adverse events | From the start of intubation until 24 hours postoperatively |
Countries
China
Contacts
CONTACTDiansan Su
Outcome results
None listed