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Double Lumen Tube versus Bronchial Blocker for Lung Isolation in Thoracic Surgery
Stuart Pasch1, Michael Mazzei2, Charles Bakhos2, Abbas Abbas2, Roman Petrov2
1Cooper University Hospital, Camden, NJ, USA, 2Temple University Hospital, Philadelphia, PA, USA

OBJECTIVE: There are two approaches for lung isolation- double lumen tube (DLT) or bronchial blocker (BB) with significant bias toward one or the other method. We sought to evaluate application of these two different techniques in a busy academic thoracic surgery setting.
METHODS: A retrospective review of 1191 thoracic procedures between August 2016 and December 2018 was conducted at Temple University Hospital (TUH) and Fox Chase Cancer Center (FCCC). Statistical analysis was performed on SPSS software.
RESULTS: 864 (72.5%) DLT and 327 (27.5%) BB cases were analyzed. 332 cases at TUH included 19 (5.7%) DLT and 313 (94.3%) BB. 859 cases at FCCC included 845 (98.4%) DLT and 14 (1.6%) BB. DLT had shorter from "Induction" to "Procedure Start" time (29.6 † 17.0 min vs 48.4 † 21.1 min). BB had shorter "Procedure Start" to "Procedure End" time (165.6 † 98.2 min vs 189.1 † 98.7 min (P=<0.001). There was no difference between "In Room" until "Procedure End" time (230.8 † 101.4 min (DLT) vs 255.8 † 100.2 min (BB). Overall, there were minimal differences in the surgical outcomes and complications.
CONCLUSIONS: This study demonstrated that bronchial blocker is a safe and acceptable technique for lung isolation. Bronchial blocker carries advantages due to smaller outer diameter while larger internal diameter, obviating need for tube exchange for toilet bronchoscopy or prolonged postoperative ventilation.


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