Left-Sided Double-Lumen Tube vs EZ-Blocker for One-Lung Ventilation in Thoracic Surgery : A Systematic Review and Meta-Analysis
Background. The EZ-Blocker is the newest generation of bronchial blocker and offers a potential alternative to left-sided double lumen tubes for lung isolation and one-lung ventilation during thoracic surgery. Methods. Databases were searched for randomized controlled trials comparing left-sided double lumen tube to the EZ-Blocker for one-lung ventilation during thoracic surgery. The time for placement, incidence of intraoperative displacement, and surgeons' rating of lung collapse quality were designated as coprimary outcomes. The safety profiles of the two devices, including the incidence of airway trauma and post-extubation discomfort were also examined. Results. Six randomized controlled trials (495 patients) were analyzed. Compared to the EZ-Blocker, the left-sided double lumen tube was faster to place by a weighted mean difference of [95% CI] of -61.24 seconds [-102.48, -20.00] (P = .004) and was much less likely to become displaced during lung isolation with an odds ratio [95% CI] of .56 [.34, .91] (P = .02). The left-sided double lumen tube and the EZ-Blocker provided similar surgeon-rated quality of lung isolation. Although the left-sided double lumen tube caused a greater degree of post-extubation sore throat, there was a similar incidence of carinal trauma and post-extubation hoarseness compared to the EZ-Blocker. Conclusion. Our analysis suggests that the left-sided double lumen tube can be placed more quickly and is less prone to intraoperative displacement compared to the EZ-Blocker; the quality of lung collapse is similar. Thus, evidence appears to support the continued utilization of the left-sided double lumen tube for routine thoracic surgery requiring one-lung ventilation.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
|---|---|
| Enthalten in: |
Seminars in cardiothoracic and vascular anesthesia - 27(2023), 3 vom: 04. Sept., Seite 171-180 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kumar, Nicolas [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Bronchial blockers |
|---|
| Anmerkungen: |
Date Completed 12.10.2023 Date Revised 18.10.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/10892532231184781 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM358493889 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM358493889 | ||
| 003 | DE-627 | ||
| 005 | 20231226074847.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/10892532231184781 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1194.xml |
| 035 | |a (DE-627)NLM358493889 | ||
| 035 | |a (NLM)37347963 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kumar, Nicolas |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Left-Sided Double-Lumen Tube vs EZ-Blocker for One-Lung Ventilation in Thoracic Surgery |b A Systematic Review and Meta-Analysis |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 12.10.2023 | ||
| 500 | |a Date Revised 18.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Background. The EZ-Blocker is the newest generation of bronchial blocker and offers a potential alternative to left-sided double lumen tubes for lung isolation and one-lung ventilation during thoracic surgery. Methods. Databases were searched for randomized controlled trials comparing left-sided double lumen tube to the EZ-Blocker for one-lung ventilation during thoracic surgery. The time for placement, incidence of intraoperative displacement, and surgeons' rating of lung collapse quality were designated as coprimary outcomes. The safety profiles of the two devices, including the incidence of airway trauma and post-extubation discomfort were also examined. Results. Six randomized controlled trials (495 patients) were analyzed. Compared to the EZ-Blocker, the left-sided double lumen tube was faster to place by a weighted mean difference of [95% CI] of -61.24 seconds [-102.48, -20.00] (P = .004) and was much less likely to become displaced during lung isolation with an odds ratio [95% CI] of .56 [.34, .91] (P = .02). The left-sided double lumen tube and the EZ-Blocker provided similar surgeon-rated quality of lung isolation. Although the left-sided double lumen tube caused a greater degree of post-extubation sore throat, there was a similar incidence of carinal trauma and post-extubation hoarseness compared to the EZ-Blocker. Conclusion. Our analysis suggests that the left-sided double lumen tube can be placed more quickly and is less prone to intraoperative displacement compared to the EZ-Blocker; the quality of lung collapse is similar. Thus, evidence appears to support the continued utilization of the left-sided double lumen tube for routine thoracic surgery requiring one-lung ventilation | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a EZ blocker | |
| 650 | 4 | |a bronchial blockers | |
| 650 | 4 | |a double lumen tubes | |
| 650 | 4 | |a lung isolation | |
| 650 | 4 | |a thoracic surgery | |
| 700 | 1 | |a Mitchell, Justin |e verfasserin |4 aut | |
| 700 | 1 | |a Siemens, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Deiparine, Selina |e verfasserin |4 aut | |
| 700 | 1 | |a Saddawi-Konefka, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Hussain, Nasir |e verfasserin |4 aut | |
| 700 | 1 | |a Iyer, Manoj H |e verfasserin |4 aut | |
| 700 | 1 | |a Essandoh, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Sawyer, Tamara R |e verfasserin |4 aut | |
| 700 | 1 | |a Hao, David |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Seminars in cardiothoracic and vascular anesthesia |d 1998 |g 27(2023), 3 vom: 04. Sept., Seite 171-180 |w (DE-627)NLM097456594 |x 1940-5596 |7 nnns |
| 773 | 1 | 8 | |g volume:27 |g year:2023 |g number:3 |g day:04 |g month:09 |g pages:171-180 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/10892532231184781 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 27 |j 2023 |e 3 |b 04 |c 09 |h 171-180 | ||