• Zhuo Liu, Li Zhao, Qianqian Jia, Xiaochun Yang, Shu Juan Liang, and Wensheng He.
• Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China. Electronic address: liuzhuo2011@yeah.net.
• J. Cardiothorac. Vasc. Anesth. 2018 Apr 1; 32 (2): 855-859.

ObjectiveThe main objective of this study was to assess the feasibility and accuracy of measuring the distance between the vocal cord and carina using chest computer tomography (CT) as a guide for the intubation of a left-sided double-lumen tube (LDLT).DesignSingle-center, prospective, randomized study.SettingLocal hospital in China.ParticipantsSixty adult patients undergoing elective thoracic surgery requiring an LDLT for one lung ventilation were enrolled in this study.InterventionsPatients were randomly allocated to the following 2 groups: blind intubation group (B group, n = 30) or chest computed tomography-guided group (C group, n = 30). The placement of the LDLT was accomplished using 1 of the 2 intubation methods. After intubation, an independent anesthesiologist evaluated the position of the LDLT and carina and bronchial injuries using fiber optic bronchoscopy. The number of optimal positions, the time for LDLT intubation, the time for fiber optic bronchoscope confirmation, and carina and bronchial injuries were recorded.ResultsSixteen of 30 intubations in the B group were in optimal position, whereas 27 of 30 intubations in the C group were in optimal position; the difference was statistically significant (p < 0.01). The time for intubation of the LDLT took 118.0 ± 26.2 seconds in the B group and 71.5 ± 8.7 seconds in the C group (p < 0.01). The time for position confirmation using fiber optic bronchoscope took 40.8 ± 15.8 seconds in the B group and 18.7 ± 7.9 seconds in the C group (p < 0.05). The incidences of carina and bronchial injuries were obviously lower in the C group (occurred in 3 of 30 cases) than in the B group (11 of 30 cases) p < 0.05. The incidences of postoperative sore throat and hoarseness showed no significant differences between the 2 groups (p > 0.05).ConclusionThis study demonstrated that the method of measuring the distance between the vocal cord and carina according to the chest CT as a guide for the intubation of LDLT is more effective and more accurate than the blind intubation method.Copyright © 2017 Elsevier Inc. All rights reserved.

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