New Measures for Tracheobronchial Anatomy

NCT02366455 | Completed

• 1 other identifier: IUCPQ-ATB2014
• Study Type: observational
• Target: 106
• Locations: 0 countries
• Sites: N/A

Brief Summary

The right-sided double lumen endobronchial tube (R-DLT) is seldom. The principal cause of reticence for using the R-DLT are the difficult positioning of its lateral orifice in front of the origin of the right upper lobe (RUL) and the variability of the length of the right main stem bronchus (RMSB). Both the angle between the right upper lobe (RUL) bronchus origin and the RMSB and the length of the RMSB can be measured with high resolution CT-scan. These measures can be useful in clinical practice as they help to determine when a R-DLT should not be used or used with caution when facing a large variation of the angle of the RUL or a proximal implantation of a RUL bronchus .

Conditions

Thoracic CT-scan; Right Upper Lobe Anatomy; Right Sided Double Lumen Endobronchial Tube

Outcome Measures

Primary Outcomes (2)

• Measurement of the length of the right mainstem bronchus

  1 day

• Measure of the right upper lobe bronchus antero-posterior angulation

  1 day

Study Arms (1)

Thoracic CT-Scan

Measurement of the length of the right main stem bronchus and of the right upper lobe bronchus antero-posterior angulation on consecutive thoracic CT-Scan reconstruction

Procedure: Measurement of the length of the right main stem bronchus; Procedure: Measurement of the right upper lobe bronchus antero-posterior angulation

Interventions

Measurement of the length of the right main stem bronchus PROCEDURE

Measurement of the length of the right main stem bronchus on CT-Scan

Thoracic CT-Scan

Measurement of the right upper lobe bronchus antero-posterior angulation PROCEDURE

Measurement of the right upper lobe bronchus antero-posterior angulation on CT-Scan

Thoracic CT-Scan

Eligibility Criteria

• Age: 35 Years - 85 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Evaluation of radiological consecutives thoracic CT-Scan reconstruction in a tertiary university hearth and lung institute. Patients had CT- scan for diagnosis or follow-up purposes

You may qualify if:

• Aged 35 to 85 years old

You may not qualify if:

• Unavailable weight and height
• Tracheobronchial tree pathologies (e.g. : tracheomalacia, tracheobronchomegaly, endobronchial lesions, bronchiectasis, etc.)
• Mediastinal pathologies inducing an extrinsic compression of the tracheobronchial tree.
• Pulmonary pathologies inducing a deformation of the tracheobronchial tree (e.g.: retraction, important atelectasis, pulmonary fibrosis, chronic tuberculosis, etc.)
• Patients that have had a treatment or surgery inducing a deformation of the tracheobronchial tree (e.g.: lobectomy, pneumonectomy, radiotherapy)
• An important musculoskeletal deformity at the thoracic level
• Low-quality CT scan exams (e.g.: significant kinetic artifacts where measurements should be taken

Sponsors & Collaborators

• Laval University: lead

Related Publications (17)

• McKenna MJ, Wilson RS, Botelho RJ. Right upper lobe obstruction with right-sided double-lumen endobronchial tubes: a comparison of two tube types. J Cardiothorac Anesth. 1988 Dec;2(6):734-40. doi: 10.1016/0888-6296(88)90096-8.

  PMID: 17171882 BACKGROUND

• Klein U, Karzai W, Bloos F, Wohlfarth M, Gottschall R, Fritz H, Gugel M, Seifert A. Role of fiberoptic bronchoscopy in conjunction with the use of double-lumen tubes for thoracic anesthesia: a prospective study. Anesthesiology. 1998 Feb;88(2):346-50. doi: 10.1097/00000542-199802000-00012.

  PMID: 9477054 BACKGROUND

• Benumof JL, Partridge BL, Salvatierra C, Keating J. Margin of safety in positioning modern double-lumen endotracheal tubes. Anesthesiology. 1987 Nov;67(5):729-38. doi: 10.1097/00000542-198711000-00018.

  PMID: 3674473 BACKGROUND

• Benumof JL. Improving the design and function of double-lumen tubes. J Cardiothorac Anesth. 1988 Dec;2(6):729-33. doi: 10.1016/0888-6296(88)90095-6. No abstract available.

  PMID: 17171881 BACKGROUND

• Hurford WE, Alfille PH. A quality improvement study of the placement and complications of double-lumen endobronchial tubes. J Cardiothorac Vasc Anesth. 1993 Oct;7(5):517-20. doi: 10.1016/1053-0770(93)90305-5.

  PMID: 8268428 BACKGROUND

• Benumof JL. The position of a double-lumen tube should be routinely determined by fiberoptic bronchoscopy. J Cardiothorac Vasc Anesth. 1993 Oct;7(5):513-4. doi: 10.1016/1053-0770(93)90303-3. No abstract available.

  PMID: 8268426 BACKGROUND

• Campos JH, Massa FC, Kernstine KH. The incidence of right upper-lobe collapse when comparing a right-sided double-lumen tube versus a modified left double-lumen tube for left-sided thoracic surgery. Anesth Analg. 2000 Mar;90(3):535-40. doi: 10.1097/00000539-200003000-00007.

  PMID: 10702432 BACKGROUND

• Ehrenfeld JM, Walsh JL, Sandberg WS. Right- and left-sided Mallinckrodt double-lumen tubes have identical clinical performance. Anesth Analg. 2008 Jun;106(6):1847-52. doi: 10.1213/ane.0b013e31816f24d5.

  PMID: 18499621 BACKGROUND

• Ehrenfeld JM, Mulvoy W, Sandberg WS. Performance comparison of right- and left-sided double-lumen tubes among infrequent users. J Cardiothorac Vasc Anesth. 2010 Aug;24(4):598-601. doi: 10.1053/j.jvca.2009.09.007. Epub 2009 Nov 25.

  PMID: 19942453 BACKGROUND

• Slinger P. The clinical use of right-sided double-lumen tubes. Can J Anaesth. 2010 Apr;57(4):293-300. doi: 10.1007/s12630-009-9262-z. No abstract available. English, French.

  PMID: 20058114 BACKGROUND

• Ikeno S, Mitsuhata H, Saito K, Hirabayashi Y, Akazawa S, Kasuda H, Shimizu R. Airway management for patients with a tracheal bronchus. Br J Anaesth. 1996 Apr;76(4):573-5. doi: 10.1093/bja/76.4.573.

  PMID: 8652335 BACKGROUND

• Kim JH, Park SH, Han SH, Nahm FS, Jung CK, Kim KM. The distance between the carina and the distal margin of the right upper lobe orifice measured by computerised tomography as a guide to right-sided double-lumen endobronchial tube use. Anaesthesia. 2013 Jul;68(7):700-5. doi: 10.1111/anae.12208. Epub 2013 May 8.

  PMID: 23656604 BACKGROUND

• Bussieres JS, Lacasse Y, Cote D, Beauvais M, St-Onge S, Lemieux J, Soucy J. Modified right-sided Broncho-Cath double lumen tube improves endobronchial positioning: a randomized study. Can J Anaesth. 2007 Apr;54(4):276-82. doi: 10.1007/BF03022772.

  PMID: 17400979 BACKGROUND

• Hagihira S, Takashina M, Mashimo T. Application of a newly designed right-sided, double-lumen endobronchial tube in patients with a very short right mainstem bronchus. Anesthesiology. 2008 Sep;109(3):565-8. doi: 10.1097/ALN.0b013e31818344bd. No abstract available.

  PMID: 18719454 BACKGROUND

• Bussieres JS, Somma J. Modified and newly designed right-sided double-lumen endobronchial tubes are complementary. Anesthesiology. 2009 May;110(5):1190; author reply 1190-1. doi: 10.1097/ALN.0b013e31819fac6a. No abstract available.

  PMID: 19387186 BACKGROUND

• Lohser J, Umedaly HS, Fitzmaurice BG. Do-it-yourself modified right-sided Broncho-Cath double lumen tube. Can J Anaesth. 2007 Aug;54(8):675; author reply 675. doi: 10.1007/BF03022963. No abstract available.

  PMID: 17666722 BACKGROUND

• Fischler M. A call to Mallinckrodt for a modified right-sided Broncho-Cath double lumen tube. Can J Anaesth. 2007 Dec;54(12):1029-30; author reply 1030. doi: 10.1007/BF03016642. No abstract available.

  PMID: 18056217 BACKGROUND

Study Officials

• Jean S. Bussières, M.D.

  Laval University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Anesthesiologist

Study Record Dates

• First Submitted: February 12, 2015
• First Posted: February 19, 2015
• Study Start: August 1, 2012
• Primary Completion: December 1, 2016
• Study Completion: December 1, 2016
• Last Updated: April 10, 2020

Record last verified: 2020-04