Journal of clinical anesthesia · 2025
Lung isolation with a bronchial blocker placed in the lateral position for patients undergoing thoracic surgery: A multicenter, randomized clinical trial.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Li Hui, Chu Lihua, Ye Hui, Zhang Yixiao, Li Min, Hua Yejing, Zhang Jinhua, Hu Huiyi, Wen Tingting, Zhao Jie, Wan Haifang, Huang Lixia, Lou Yi, Tang Jing, Yan Zhenyi, Duan Gongchen, Wu Jimin, Wang Chuanguang, Lu Yaping, Shen Xu, Huang Cuiwan, Song Cheng, Wang Yan, Zeng Congli, Xie Guohao, Fang Xiangming
Аннотация
UNLABELLED: Study objective Accurate bronchial blocker placement is essential for effective lung isolation during thoracic surgery. Approximately one-third of patients experience bronchial blocker malposition during the transition from the supine to lateral decubitus position. It has been unclear whether bronchial blocker placement directly in the lateral position can reduce the incidence of malposition. This study investigated the incidence of bronchial blocker malposition in the lateral versus supine position and evaluated the effectiveness of lateral placement.
PATIENTS: Adults aged ≥18 years scheduled for thoracic surgery were enrolled.
SETTING: Seven tertiary hospitals in China.
INTERVENTIONS: Bronchial blockers were placed either in the lateral or supine position.
MEASUREMENTS: The primary outcome was the incidence of bronchial blocker malposition. Secondary outcomes included the times of bronchial blocker reposition, perioperative complications, intubation duration, and satisfaction scores.
MAIN RESULTS: Among 324 patients who underwent randomization, 306 completed the study (152 in the lateral group and 154 in the supine group). The incidence of bronchial blocker malposition was significantly lower in the lateral group (1/152 (0.7 %)) than in the supine group 39/154 (25.3 %), P < 0.001). The times of bronchial blocker reposition was also lower in the lateral group (median [interquartile range]: 0 [0,0]) than in the supine group (1.0 [1.0, 2.0], P < 0.001). Lateral bronchial blocker placement was associated with lower incidences of postural injury (P < 0.001). The median intubation duration (single-lumen tube intubation plus bronchial blocker placement) was similar between the two groups (P = 0.089). Patients and surgeons reported higher satisfaction scores in the lateral group (P < 0.001).
CONCLUSIONS: Lateral bronchial blocker placement reduced the incidence of malposition in patients undergoing thoracic surgery; it was associated with fewer complications and higher satisfaction scores. These findings indicate that lateral placement is an effective approach with substantial advantages over conventional supine placement. Clinial trial registration:NCT05482230.
PATIENTS: Adults aged ≥18 years scheduled for thoracic surgery were enrolled.
SETTING: Seven tertiary hospitals in China.
INTERVENTIONS: Bronchial blockers were placed either in the lateral or supine position.
MEASUREMENTS: The primary outcome was the incidence of bronchial blocker malposition. Secondary outcomes included the times of bronchial blocker reposition, perioperative complications, intubation duration, and satisfaction scores.
MAIN RESULTS: Among 324 patients who underwent randomization, 306 completed the study (152 in the lateral group and 154 in the supine group). The incidence of bronchial blocker malposition was significantly lower in the lateral group (1/152 (0.7 %)) than in the supine group 39/154 (25.3 %), P < 0.001). The times of bronchial blocker reposition was also lower in the lateral group (median [interquartile range]: 0 [0,0]) than in the supine group (1.0 [1.0, 2.0], P < 0.001). Lateral bronchial blocker placement was associated with lower incidences of postural injury (P < 0.001). The median intubation duration (single-lumen tube intubation plus bronchial blocker placement) was similar between the two groups (P = 0.089). Patients and surgeons reported higher satisfaction scores in the lateral group (P < 0.001).
CONCLUSIONS: Lateral bronchial blocker placement reduced the incidence of malposition in patients undergoing thoracic surgery; it was associated with fewer complications and higher satisfaction scores. These findings indicate that lateral placement is an effective approach with substantial advantages over conventional supine placement. Clinial trial registration:NCT05482230.