1
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Moharir A, Yamaguchi Y, Aldrink JH, Martinez A, Arce-Villalobos M, Yemele Kitio SA, Rice-Weimer J, Tobias JD. Point-of-Care Lung Ultrasound to Evaluate Lung Isolation During One-Lung Ventilation in Children: A Blinded Observational Feasibility Study. Anesth Analg 2024:00000539-990000000-00944. [PMID: 39269907 DOI: 10.1213/ane.0000000000007155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
BACKGROUND Minimally invasive thoracic surgical techniques require effective lung isolation using one-lung ventilation (OLV). Verification of lung isolation may be confirmed by auscultation, visual confirmation using fiberoptic bronchoscopy (FOB), or more recently, point-of-care ultrasound (POCUS). The aim of this study was to prospectively compare lung ultrasound with clinical auscultation to confirm OLV before thoracic surgery in pediatric patients. METHODS This prospectively blinded feasibility study included 40 patients ranging in age from 0 to 20 years. After confirmation of lung separation by the primary anesthesia team using FOB, the sonographer and the auscultator, both blinded to the laterality of surgery and lung separation, entered the operating room. The sonographer evaluated for pleural lung sliding and the auscultator listened for breath sounds. Successful lung separation was definitively confirmed by direct visualization of lung collapse during the operation. RESULTS In confirming effective single-lung ventilation, lung ultrasound had a diagnostic accuracy of 95% (95% confidence interval [CI], 82.7%-98.5%). In contrast, auscultation could only reliably confirm lung isolation with 68% accuracy (95% CI, 51.5%-80.4%). The McNemar test showed a statistically significant difference between the use of lung ultrasound and auscultation (P < .001). The median time to perform ultrasonography was 67 seconds (interquartile range [IQR], 46-142) and the median time to perform auscultation was 21 seconds (IQR, 10-32). CONCLUSIONS Based on the initial results of our feasibility trial, lung ultrasound proved to be a fast and reliable method to verify single-lung ventilation in pediatric patients presenting for thoracic surgery with a high degree of diagnostic accuracy.
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Affiliation(s)
- Alok Moharir
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
- Department of Anesthesiology & Pain Medicine, The Ohio State University, Columbus, Ohio
| | - Yoshikazu Yamaguchi
- Department of Anesthesiology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Jennifer H Aldrink
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Andrea Martinez
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Mauricio Arce-Villalobos
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | | | - Julie Rice-Weimer
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Joseph D Tobias
- From the Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio
- Department of Anesthesiology & Pain Medicine, The Ohio State University, Columbus, Ohio
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2
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Tognon C, Pulvirenti R, Pizzi S, Zuliani M, Cortese G, Esposito C, Gamba P. Lung Ultrasound to Assess One Lung Ventilation: A Pediatric Case Series. J Laparoendosc Adv Surg Tech A 2022; 32:566-570. [PMID: 35353608 DOI: 10.1089/lap.2021.0839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: One lung ventilation (OLV) is the preferred ventilation technique for thoracoscopy as it provides a better exposure of the operative field and grants the protection of the healthy lung. Preoperative evaluation of lung exclusion is necessary and different methods are available. In recent years lung ultrasound (US) gained popularity and its use for monitoring the endotracheal tube position is widely reported. The existing evidence on adults addresses lung US as effective, yet only few data are available in children. Therefore, we present our experience with lung US as verification method for pediatric OLV. Methods: All patients undergoing OLV for video-assisted thoracoscopic surgery from January 2019 to May 2021 and for whom lung exclusion was confirmed through lung US were involved. Lung exclusion was considered effective when absence of lung motion and presence of lung pulse were encountered. When lung US did not match these criteria, repositioning of the endobronchial device followed by US verification was performed. When lung US met the exclusion criteria surgery was started and direct thoracoscopic observation was used to verify lung exclusion. Results: A total of 20 patients, accounting for 22 procedures, were involved. Absence of lung motion and presence of lung pulse were assessed in the operative-side lung for all patients. Lung exclusion was confirmed through thoracoscopy. Postoperative lung US proved the reappearance of lung motion in the previously excluded lung. Conclusions: In our center experience lung US resulted to be a safe, effective, and time-saving verification method for OLV. Further studies are needed to define its sensitivity and specificity.
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Affiliation(s)
- Costanza Tognon
- Anesthesiology Pediatric Unit, Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Rebecca Pulvirenti
- Pediatric Surgery Unit, Women's and Children's Health Department, University of Padova, Padova, Italy
| | - Simone Pizzi
- Anesthesiology Pediatric Unit, Mother and Child Department, G. Salesi Hospital, Ancona, Italy
| | - Monica Zuliani
- Department of Medicine, Pediatric Radiology Unit-Radiology Institute Hospital, University of Padova, Padova, Italy
| | - Giuseppe Cortese
- Unit of Anesthesia, Intensive Care and Pain Therapy, Department of General and Specialistic Surgery, Kidney Transplantation, Nephrology, Intensive Care and Pain Therapy, Federico II University of Naples, Naples, Italy
| | - Ciro Esposito
- Pediatric Surgery Unit, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Piergiorgio Gamba
- Pediatric Surgery Unit, Women's and Children's Health Department, University of Padova, Padova, Italy
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3
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Murray-Torres TM, Winch PD, Naguib AN, Tobias JD. Anesthesia for thoracic surgery in infants and children. Saudi J Anaesth 2021; 15:283-299. [PMID: 34764836 PMCID: PMC8579498 DOI: 10.4103/sja.sja_350_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022] Open
Abstract
The management of infants and children presenting for thoracic surgery poses a variety of challenges for anesthesiologists. A thorough understanding of the implications of developmental changes in cardiopulmonary anatomy and physiology, associated comorbid conditions, and the proposed surgical intervention is essential in order to provide safe and effective clinical care. This narrative review discusses the perioperative anesthetic management of pediatric patients undergoing noncardiac thoracic surgery, beginning with the preoperative assessment. The considerations for the implementation and management of one-lung ventilation (OLV) will be reviewed, and as will the anesthetic implications of different surgical procedures including bronchoscopy, mediastinoscopy, thoracotomy, and thoracoscopy. We will also discuss pediatric-specific disease processes presenting in neonates, infants, and children, with an emphasis on those with unique impact on anesthetic management.
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Affiliation(s)
- Teresa M Murray-Torres
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, Missouri, USA.,Department of Anesthesiology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Peter D Winch
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, Missouri, USA.,Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Aymen N Naguib
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, Missouri, USA.,Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Joseph D Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, Missouri, USA.,Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
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4
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Yamaguchi Y, Moharir A, Burrier C, Nomura T, Tobias JD. Point-of-Care Lung Ultrasound to Evaluate Lung Isolation During One-Lung Ventilation in Children: Narrative Review. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2020; 13:385-389. [PMID: 33235524 PMCID: PMC7680174 DOI: 10.2147/mder.s265074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/21/2020] [Indexed: 11/23/2022] Open
Abstract
This review focuses on the current technique and evidence regarding the use of point-of-care ultrasound (POCUS) to evaluate lung isolation for thorax surgery in infants and children. Previous reports in infants and children are presented. Figures and high-quality video are used to demonstrate the technique for POCUS in pediatric patients and to highlight differences between pediatric and patients. Lung sliding in B-mode and the seashore sign in M-mode suggest that the lung is ventilated. Pediatric anesthesiologists should be familiar with this technique as it is non-invasive and may also be more accurate when compared with auscultation.
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Affiliation(s)
- Yoshikazu Yamaguchi
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Anesthesiology, The Ohio State University, Columbus, OH, USA
| | - Alok Moharir
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Anesthesiology, The Ohio State University, Columbus, OH, USA
| | - Candice Burrier
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Anesthesiology, The Ohio State University, Columbus, OH, USA
| | - Takeshi Nomura
- Department of Intensive Care Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Joseph D Tobias
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Anesthesiology, The Ohio State University, Columbus, OH, USA
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5
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Alerhand S, Tsung JW. Unmasking the Lung Pulse for Detection of Endobronchial Intubation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:2105-2109. [PMID: 32356589 DOI: 10.1002/jum.15318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
The ultrasound lung pulse for detecting endobronchial intubation was first described in 2003 in the only study to date assessing its accuracy. It refers to rhythmic movement of the visceral pleura along the stationary parietal pleura as cardiac vibrations transmit through a motionless, airless lung. Compared to delayed visualization on chest radiography, this artifact immediately detects physiologic atelectasis. There is a scarcity of studies assessing the lung pulse, while several others that encountered this artifact did not even identify it. The lung pulse is useful for immediate detection of endobronchial intubation, but it remains unrecognized and underused by physicians.
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Affiliation(s)
- Stephen Alerhand
- Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - James W Tsung
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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6
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Chung JY, Go Y, Jang YS, Lee BJ, Seo H. Lung sonography can improve the specificity of determination of left-sided double-lumen tracheal tube position in both novices and experts: a randomised prospective study. J Int Med Res 2020; 48:300060520964369. [PMID: 33103504 PMCID: PMC7645395 DOI: 10.1177/0300060520964369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective Lung sonography can be helpful to determine the position of a left-sided double-lumen tube (DLT). However, clinical experience is required for correct assessment. We investigated whether lung sonography can improve the diagnostic efficacy of determining the DLT position in novices and experts. Methods In this randomised prospective clinical study, 88 patients were allocated to two groups using auscultation or lung sonography for initial assessment of the DLT position. In each group, two repeated assessments were performed; the first was performed by a novice, and the second was performed by an expert. The final DLT position was confirmed by fibre-optic bronchoscopy. The primary outcome was the diagnostic efficacy (including overall accuracy, sensitivity, and specificity) in confirming the DLT position. Results In both the novices and experts, the specificity of determining the DLT position was significantly higher with lung sonography than auscultation (60.0% vs. 21.7% and 66.7% vs. 37.5%, respectively). Additionally, the predictability of an incorrect position was similar between the novices and experts using lung sonography (area under the curve of 0.665 and 0.690, respectively). Conclusions Lung sonography can improve the diagnostic efficacy of detecting an incorrect DLT position in both novices and experts.
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Affiliation(s)
- Jun-Young Chung
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - YoonJu Go
- Department of Anesthesiology and Pain Medicine, Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Yong Seok Jang
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Bong-Jae Lee
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyungseok Seo
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
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7
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Rodrigues A, Salgado H. [Lung exclusion in neonates - techniques and the role of ultrasound]. Rev Bras Anestesiol 2020; 70:307-308. [PMID: 32482357 DOI: 10.1016/j.bjan.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/25/2020] [Accepted: 02/08/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Helena Salgado
- Hospital de Braga, Departamento de Anestesiologia, Braga, Portugal
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8
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Rodrigues A, Salgado H. Lung exclusion in neonates - techniques and the role of ultrasound. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2020. [PMID: 32482357 PMCID: PMC9373092 DOI: 10.1016/j.bjane.2020.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Helena Salgado
- Hospital de Braga, Departamento de Anestesiologia, Braga, Portugal
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9
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Rodrigues A, Alves P, Hipólito C, Salgado H. [Will ultrasound replace the stethoscope?: a case report on neonatal one-lung ventilation]. Rev Bras Anestesiol 2019; 69:514-516. [PMID: 31630850 DOI: 10.1016/j.bjan.2019.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/17/2019] [Accepted: 06/29/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES One-lung ventilation and selective intubation in neonates can be challenging due to intrinsic physiological specificities and material available. Ultrasound (US) is being increasingly used in many extents of anaesthesiology including confirmation of endotracheal tube position. CASE REPORT We present a case report of a neonate proposed for pulmonary lobectomy by thoracoscopy in which lung exclusion was confirmed by ultrasound. CONCLUSION US is a rapid, more sensitive and specific method than auscultation to evaluate tracheal intubation and lung exclusion.
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10
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Rodrigues A, Alves P, Hipólito C, Salgado H. Will ultrasound replace the stethoscope?: a case report on neonatal one-lung ventilation. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2019. [PMID: 31630850 PMCID: PMC9391872 DOI: 10.1016/j.bjane.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background and objectives One-lung ventilation and selective intubation in neonates can be challenging due to intrinsic physiological specificities and material available. Ultrasound (US) is being increasingly used in many extents of anaesthesiology including confirmation of endotracheal tube position. Case report We present a case report of a neonate proposed for pulmonary lobectomy by thoracoscopy in which lung exclusion was confirmed by ultrasound. Conclusion US is a rapid, more sensitive and specific method than auscultation to evaluate tracheal intubation and lung exclusion.
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11
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Yamaguchi Y, Moharir A, Burrier C, Tobias JD. Point-of-care lung ultrasound to evaluate lung isolation during one-lung ventilation in children: A case report. Saudi J Anaesth 2019; 13:243-245. [PMID: 31333372 PMCID: PMC6625300 DOI: 10.4103/sja.sja_115_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Minimally invasive thoracic surgical techniques require effective lung separation using one-lung ventilation (OLV). Verification of lung isolation may be confirmed by auscultation, visual confirmation using fiberoptic bronchoscopy, or more recently, point-of-care ultrasound (POCUS). We describe anecdotal experience with POCUS to guide OLV during robotic-assisted thoracic surgery in a child. Techniques to confirm thoracic separation are reviewed and potential advantages of POCUS discussed.
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Affiliation(s)
- Yoshikazu Yamaguchi
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States
| | - Alok Moharir
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States.,Department of Anesthesiology, The Ohio State University, Columbus, Ohio, United States
| | - Candice Burrier
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States.,Department of Anesthesiology, The Ohio State University, Columbus, Ohio, United States
| | - Joseph D Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, United States.,Department of Anesthesiology, The Ohio State University, Columbus, Ohio, United States
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12
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Kang H, Lee S, Park H, Kim Y, Ko Y, Kim YH, Hong B. Ultrasound-guided perioperative management of 28-month-old patient with congenital diaphragmatic eventration. SAGE Open Med Case Rep 2019; 7:2050313X19827737. [PMID: 30800303 PMCID: PMC6378513 DOI: 10.1177/2050313x19827737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 01/10/2019] [Indexed: 11/29/2022] Open
Abstract
Diaphragmatic eventration is a rare anomaly. When patients with this condition undergo general anesthesia, anesthetic management should be performed with particular care owing to the risk of diaphragmatic rupture. Such a rupture can be perioperatively diagnosed using multiple tools including lung ultrasonography. This case report describes the anesthetic management of a male infant with osteochondroma in the distal ulna, presenting with diaphragmatic eventration on the right side.
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Affiliation(s)
- Hyemin Kang
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Sangmin Lee
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Hyunwoo Park
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Yeojung Kim
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - YoungKwon Ko
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.,Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Yoon-Hee Kim
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.,Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Boohwi Hong
- Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.,Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
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13
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Parab SY, Kumar P, Divatia JV, Sharma K. A prospective randomized controlled double-blind study comparing auscultation and lung ultrasonography in the assessment of double lumen tube position in elective thoracic surgeries involving one lung ventilation at a tertiary care cancer institute. Korean J Anesthesiol 2018; 72:24-31. [PMID: 30205667 PMCID: PMC6369345 DOI: 10.4097/kja.d.17.00081] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 09/04/2018] [Indexed: 11/14/2022] Open
Abstract
Background As lung ultrasound (LUS) can be used to identify regional lung ventilation and collapse, we hypothesize that LUS can be better than auscultation in assessing lung isolation and determining double lumen tube (DLT) position. Methods A randomized controlled study was conducted in tertiary care cancer institute from November 2014 to December 2015, including 100 adult patients undergoing elective thoracic surgeries. Patients with tracheostomy, difficult airway and pleural-based pathologies were excluded. After anesthesia induction and DLT insertion, patients were randomized into group A (auscultation) and group B (LUS). Regional ventilation was assessed by experienced anesthesiologists using the respective method for each group. Final confirmation of DLT position with a bronchoscope was performed by a blinded anesthesiologist. Contingency tables were plotted to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for each method. Results Data from 91 patients were analyzed (group A = 47, group B = 44). Compared with auscultation, LUS had significantly higher sensitivity (94.1% vs. 73.3%, P = 0.010), PPV (57.1% vs. 35.5%, P = 0.044), NPV (93.8% vs. 75.0%, P = 0.018), accuracy (70.5% vs. 48.9%, P = 0.036) and required longer median time (161.5 vs. 114 s, P < 0.001) for assessment of DLT position. Differences in specificity (55.6% vs. 37.5%, P = 0.101) and area under curve (0.748; 95% CI: 0.604–0.893 vs. 0.554, 95% CI: 0.379–0.730; P = 0.109) were not significant. Conclusions Compared to auscultation, LUS is a superior method for assessing lung isolation and determining DLT position.
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Affiliation(s)
- Swapnil Y Parab
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Prashant Kumar
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Jigeeshu V Divatia
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Kailash Sharma
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
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14
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Ultrasound-guided selective intubation in a preterm neonate undergoing type-C esophageal athresia correction. Case report. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2018. [DOI: 10.1097/cj9.0000000000000014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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