Effect of Head Turn on Double-Lumen Tube Alignment

NCT07755722 | Completed

• 2 other identifiers: 2023-12-003BCFV115C-038
• Study Type: interventional
• Target: 35
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluated how simple external airway maneuvers affect the alignment of the left main bronchus during placement of a left-sided double-lumen endotracheal tube. Adults undergoing elective thoracic surgery requiring one-lung ventilation were enrolled. During double-lumen tube placement, a fiberoptic bronchoscope was used to continuously view the airway. Each participant underwent three sequential maneuvers: rightward displacement of the trachea, turning the head 45 degrees to the right, and turning the head 45 degrees to the left. The investigators measured how far the opening of the left main bronchus moved on the bronchoscopic image and whether it crossed the center of the image. The purpose of the study was to determine how these maneuvers change airway alignment and whether they may help guide a left-sided double-lumen tube toward the left main bronchus.

Conditions

Double-Lumen Endotracheal Tube Placement

Keywords

Double-Lumen Endotracheal Tube; Head Rotation; One-Lung Ventilation; Fiberoptic Bronchoscopy; Airway Management

Outcome Measures

Primary Outcomes (1)

• Midline Crossing of the Left Main Bronchus

  Midline crossing was defined as a change in the position of the left main bronchus from the left side to the right side of the midline of the bronchoscopic image following each airway maneuver. The position of the left main bronchus was assessed using real-time fiberoptic bronchoscopy with the bronchoscope maintained 2 cm proximal to the carina. Midline crossing was recorded as a binary outcome (yes/no) for each maneuver.

  During the airway maneuver, immediately after each maneuver was applied

Secondary Outcomes (1)

• Relative Horizontal Displacement of the Left Main Bronchus

  During the airway maneuver, immediately after each maneuver was applied

Study Arms (1)

Airway Maneuver Group

EXPERIMENTAL

Participants underwent three airway maneuvers in a predefined sequence during left-sided double-lumen tube placement: right tracheal displacement, 45° right head turn, and 45° left head turn. The airway and head position were returned to neutral between maneuvers. Bronchoscopic alignment and horizontal displacement of the left main bronchus were assessed during each maneuver.

Procedure: Right Tracheal Displacement; Procedure: Right Head Turn Maneuver; Procedure: Left Head Turn Maneuver

Interventions

Right Head Turn Maneuver PROCEDURE

The participant's head was rotated 45° to the right from the neutral position. Bronchoscopic alignment and horizontal displacement of the left main bronchus were assessed during the maneuver. The head was subsequently returned to the neutral position.

Airway Maneuver Group

Right Tracheal Displacement PROCEDURE

A lateral force was applied externally at the left cricothyroid level to displace the trachea toward the right. The force was increased until maximal bronchoscopic displacement was observed. Peak applied force was recorded using a digital force gauge. Bronchoscopic alignment and horizontal displacement of the left main bronchus were assessed during the maneuver.

Airway Maneuver Group

Left Head Turn Maneuver PROCEDURE

The participant's head was rotated 45° to the left from the neutral position. Bronchoscopic alignment and horizontal displacement of the left main bronchus were assessed during the maneuver. The head was subsequently returned to the neutral position.

Airway Maneuver Group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients scheduled for elective thoracic surgery requiring lung isolation with a left-sided double-lumen endotracheal tube
• American Society of Anesthesiologists (ASA) physical status I-III
• Provided written informed consent

You may not qualify if:

• Known severe cervical spine pathology or cervical instability
• History of cervical spine surgery
• Significant anatomical abnormalities of the upper airway
• Head or neck malignancy or obstructing airway neoplasm
• Presence of a tracheostomy

Sponsors & Collaborators

• Taipei Veterans General Hospital, Taiwan: lead

Study Sites (1)

Taipei Veterans General Hospital

Taipei, 11217, Taiwan

Location

Study Officials

• Chien-Kun Ting, MD, PhD

  Taipei Veterans General Hospital, Taiwan

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Model Details: All participants underwent the same three airway maneuvers in a predefined sequence: right tracheal displacement, 45° right head turn, and 45° left head turn. The airway and head position were returned to neutral before each subsequent maneuver. Bronchoscopic alignment and horizontal displacement of the left main bronchus were assessed during each maneuver.

Study Record Dates

• First Submitted: August 4, 2026
• First Posted: August 10, 2026
• Study Start: April 10, 2024
• Primary Completion: June 27, 2025
• Study Completion: June 27, 2025
• Last Updated: August 10, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will share
• Time Frame: Data will be available beginning after publication of the study results. No predetermined end date is planned.
• Access Criteria: De-identified individual participant data underlying the published results will be available to researchers who submit a reasonable request to the corresponding author. Requests should include the purpose of the proposed research and the data requested. Access will be subject to approval by the study investigators and applicable institutional and ethical requirements.

Locations

TW (1)