Systematic Review and Meta-Analysis of Efficiency and Safety of Double-Lumen Tube and Bronchial Blocker for One-Lung Ventilation

被引:25
作者
Palaczynski, Piotr [1 ]
Misiolek, Hanna [1 ]
Szarpak, Lukasz [2 ,3 ]
Smereka, Jacek [4 ]
Pruc, Michal [5 ]
Rydel, Mateusz [6 ]
Czyzewski, Damian [6 ]
Bialka, Szymon [1 ]
机构
[1] Med Univ Silesiaia, Fac Med Sci Zabrze, Dept Anaesthesiol & Intens Care, PL-41800 Zabrze, Poland
[2] Baylor Coll Med, Henry JN Taub Dept Emergency Med, Houston, TX 77030 USA
[3] Mar Sklodowska Curie Bialystok Oncol Ctr, Res Unit, PL-15027 Bialystok, Poland
[4] Wroclaw Med Univ, Dept Emergency Med Serv, PL-51616 Wroclaw, Poland
[5] Polish Soc Disaster Med, Res Unit, PL-05806 Warsaw, Poland
[6] Med Univ Silesiaia, Fac Med Sci Zabrze, Dept Thorac Surg, PL-41800 Zabrze, Poland
关键词
double-lumen tube; DLT; bronchial blocker; one-lung ventilation; safety; airway management; meta-analysis; ENDOTRACHEAL-TUBE; ENDOBRONCHIAL BLOCKER; THORACIC-SURGERY; RANDOMIZED-TRIAL; EZ-BLOCKER; EFFICACY; DISCONNECTION; UNIVENT; BIAS;
D O I
10.3390/jcm12051877
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
One-lung ventilation is also used in some thoracic or cardiac surgery, vascular surgery and oesophageal procedures. We conducted a search of the literature for relevant studies in PubMed, Web of Science, Embase, Scopus and Cochrane Library. The final literature search was performed on 10 December 2022. Primary outcomes included the quality of lung collapse. Secondary outcome measures included: the success of the first intubation attempt, malposition rate, time for device placement, lung collapse and adverse events occurrence. Twenty-five studies with 1636 patients were included. Excellent lung collapse among DLT and BB groups was 72.4% vs. 73.4%, respectively (OR = 1.20; 95%CI: 0.84 to 1.72; p = 0.31). The malposition rate was 25.3% vs. 31.9%, respectively (OR = 0.66; 95%CI: 0.49 to 0.88; p = 0.004). The use of DLT compared to BB was associated with a higher risk of hypoxemia (13.5% vs. 6.0%, respectively; OR = 2.27; 95%CI: 1.14 to 4.49; p = 0.02), hoarseness (25.2% vs. 13.0%; OR = 2.30; 95%CI: 1.39 to 3.82; p = 0.001), sore throat (40.3% vs. 23.3%; OR = 2.30; 95%CI: 1.68 to 3.14; p < 0.001), and bronchus/carina injuries (23.2% vs. 8.4%; OR = 3.45; 95%CI: 1.43 to 8.31; p = 0.006). The studies conducted so far on comparing DLT and BB are ambiguous. In the DLT compared to the BB group, the malposition rate was statistically significantly lower, and time to tube placement and lung collapse was shorter. However, the use of DLT compared to BB can be associated with a higher risk of hypoxemia, hoarseness, sore throat and bronchus/carina injuries. Multicenter randomized trials on larger groups of patients are needed to draw definitive conclusions regarding the superiority of any of these devices.
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页数:14
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