Lung isolation with a bronchial blocker placed in the lateral position for patients undergoing thoracic surgery: A multicenter, randomized clinical trial - 05/06/25
, Xiangming Fang, M.D. a, ⁎ Abstract |
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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Lateral placement reduced the incidence of bronchial blocker malposition. |
• | Lateral bronchial blocker placement reduced postural injuries. |
• | Lateral placement showed higher surgeons and patients satisfactory scores. |
• | Bronchial blocker placed laterally showed similar intubation time to supine position. |
Keywords : Bronchial blocker, Lateral position, Malposition, One-lung ventilation, Thoracic surgery
Plan
Vol 104
Article 111869- juin 2025 Retour au numéro
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