One lung ventilation: double-lumen tube with vs. without carinal hook

Background. One lung ventilation (OLV) has become a standard procedure for the vast majority of interventions in pulmonary surgery. The most commonly used are left sided double-lumen tubes (DLTs) which are placed into the left main bronchus and the right or left lung can be isolated. The aim of our study was to compare DLTs with and without a hook. Materials and methods. Fifty-four patients undergoing lung resection were included in the randomized, controlled, single-blinded study. Recruited patients were randomly allocated to each group (hook/without hook). Demographic data, procedural data, type of tube used, and difficult intubation criteria were recorded. Complications, according to intubation and position of the tube, were also recorded. After the operation, we aske patients about a sore throat, hoarseness, haemoptysis and their satisfaction with the procedure. Results. Baseline characteristics were well balanced between groups. Time to place DLT was shorter in the group without a hook (47.7 +/- 45.5 vs 15.8 +/- 15.1s; P=0.01). The incidence of adequate positioning at the first attempt was higher in the group with a hook and the repositioning rate was higher in the group without a hook (22.22 vs 59.25%; P=0.004). Patients in both groups suffered similar incidences of hoarseness, sore throat or postoperative haemoptysis (5/5/1 vs 3/3/0; P =0.44). Patient satisfaction was higher in the group without a hook (31.85% vs 34.81%; 0.03). Conclusion. The study showed the advantage of DLTs without a hook in comparison with DLTs with a hook. In our institution we decided to use DLTs without a hook, with fiberoptic control.