Li Haisu, Wang Hezhi, Wang Conglan, Huang Yuhan, Yuan Rui, Zhao Xiaoyi, Xu Ying
Department of Anesthesiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, People's Republic of China.
Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, People's Republic of China.
Int J Surg. 2025 Jun 1;111(6):3989-4001. doi: 10.1097/JS9.0000000000002378. Epub 2025 May 12.
Different ventilation devices, including double-lumen tube (DLT), video DLT (VDLT), and various bronchial blockers (BBs), were used for one-lung ventilation (OLV). This study aimed to assess the clinical characteristics of 12 OLV devices to identify the optimal ventilation strategy for different situations.
PubMed, Embase, Web of Science, and the Cochrane Library were searched following the PICOS principle to retrieve relevant randomized controlled trials (RCTs) up to 18 November 2023. Network meta-analysis was conducted using R 4.3.2, StataSE15, and Review Manager 5.3 software to compare the clinical characteristics of these OLV devices, including the quality of lung collapse, malposition rate, time for device placement, the success of the first intubation attempt, postoperative sore throat, and hoarseness.
In summary, this study involved 33 RCTs with a total of 2177 patients to evaluate the clinical characteristics of 12 ventilation devices. Compared to the Arndt BB, DLT provided higher lung collapse quality and was less prone to malposition. According to the Ranking probabilities, the VDLT had a shorter placement time, while the Coopdech BB (CBB) had a higher success rate on the first intubation attempt. The Cohen Flex-Tip BB resulted in less hoarseness, and the CBB had a lower incidence of sore throat.
DLT demonstrated reliable lung collapse quality. VDLT allowed for quicker placement and continuous airway monitoring. BBs had fewer complications and were easier to place but had a higher risk of malposition. Therefore, choosing an OLV device depends on the patient's clinical status and surgical needs.
不同的通气设备，包括双腔气管导管（DLT）、可视双腔气管导管（VDLT）和各种支气管封堵器（BBs），都用于单肺通气（OLV）。本研究旨在评估12种OLV设备的临床特征，以确定针对不同情况的最佳通气策略。
按照PICOS原则检索PubMed、Embase、Web of Science和Cochrane图书馆，以检索截至2023年11月18日的相关随机对照试验（RCTs）。使用R 4.3.2、StataSE®15和Review Manager 5.3软件进行网状Meta分析，以比较这些OLV设备的临床特征，包括肺萎陷质量、错位率、设备放置时间、首次插管尝试的成功率、术后咽痛和声音嘶哑。
总之，本研究纳入了33项RCTs，共2177例患者，以评估12种通气设备的临床特征。与Arndt BB相比，DLT提供了更高的肺萎陷质量，且不易发生错位。根据排序概率，VDLT的放置时间较短，而Coopdech BB（CBB）在首次插管尝试时成功率较高。Cohen Flex-Tip BB导致的声音嘶哑较少，而CBB的咽痛发生率较低。
DLT显示出可靠的肺萎陷质量。VDLT允许更快的放置和持续的气道监测。BBs并发症较少且易于放置，但错位风险较高。因此，选择OLV设备取决于患者的临床状况和手术需求。
