Trial reportJournal of cardiothoracic surgery2025
A novel technique of blindly positioning bronchial blockers for one-lung ventilation: a prospective, randomized, crossover study.
Trial report in Journal of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02981537 (Two-staged Approach in Positioning Endobronchial Blockers Without Fiberoptic Guidance), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Two-staged Approach in Positioning Endobronchial Blockers Without Fiberoptic Guidance
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral methods for blindly positioning bronchial blockers (BBs) for one-lung ventilation (OLV) have been proposed. However, these methods do not reliably ensure accurate positioning and proper direction. Here, we developed a clinically applicable two-stage maneuver by modifying a previously reported one-stage maneuver for successful insertion of a BB at the appropriate depth and direction in patients requiring lung isolation where a flexible bronchoscope (FOB) is not applicable.
methodsThis prospective, randomized, crossover study was conducted at a tertiary university hospital and included 94 patients requiring OLV for elective thoracic surgery under general anesthesia. The patients underwent the one-stage maneuver followed by the two-stage maneuver and vice versa, and the success rates of the two methods were compared. After tracheal intubation, the deflated rigid-angle BB was inserted into the endotracheal tube (ET) until a pre-marked point indicating that the BB was just protruding from the ET tip. To identify the carinal depth without FOB, the BB balloon was inflated and advanced toward the intended side whilst monitoring abrupt changes in peak inspiratory pressure and expiratory tidal volume to indicate placement at the carina. In one-stage maneuver, the BB balloon was deflated and advanced 3 cm further from the estimated carinal depth. During the two-stage maneuver, the same procedure was performed to determine the carinal depth, and the deflated BB was withdrawn and reinserted to a predetermined depth with its tip directed 90 degree toward the target bronchus. The accuracy of BB positioning for both maneuvers was evaluated by a 4-point scale, with grades 1 and 2 considered acceptable for providing OLV.
resultsBB placement was more accurate in the two-stage maneuver than in the one-stage maneuver [88.0% (81/92) vs. 73.9% (68/92), relative risk (95% confidence interval [CI]), 0.45 (0.23-0.88), P < 0.001]. This improvement was particularly significant when targeting the left main bronchus [84.8% (39/46) vs. 58.7% (27/46), relative risk (95% CI), 0.36 (0.17-0.79), P < 0.001)].
conclusionsThe novel two-stage maneuver significantly improved the success rate of blindly positioning the BB.
trial registrationThis study was registered in ClinicalTrials.gov (NCT02981537) on December 05, 2016.
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