Appropriate tube temperature for fiberoptic bronchoscope-guided intubation of thermally softened double-lumen endotracheal tubes: A CONSORT-compliant article

Medicine (Baltimore). 2022 Oct 7;101(40):e29999. doi: 10.1097/MD.0000000000029999.

Abstract

Background: To compare the effects of thermal softening of double-lumen endotracheal tubes (DLT) at different temperatures during fiberoptic bronchoscopy (FOB)-guided intubation.

Methods: We randomly divided 144 patients undergoing thoracic surgery into 4 groups as follows: T1 (T = 24 ± 1°C, n = 36), T2 (T = 36 ± 1°C, n = 36), T3 (T = 40 ± 1°C, n = 36), and T4 (T = 48 ± 1°C, n = 36). All groups underwent FOB-guided double-lumen endotracheal intubation and positioning. We recorded the duration of positioning and intubation using DLT, intubation resistance (IR), the success rate of the first attempt at endotracheal intubation, and the incidence of postoperative vocal cord injury and hoarseness.

Results: The time to intubation was longer in the T1 group than that in the T2, T3, and T4 groups (P < .05). The time for positioning was longer in the T4 group than that in the T1, T2, and T3 groups (P < .05). IR was lower in the T3 and T4 groups than those in T1 and T2 groups (P < .05). The success rate of the first attempt at endotracheal intubation was higher in the T2, T3, and T4 groups than that in the T1 group (P < .05). Postoperative glottic injury and hoarseness were higher in the T1 and T2 groups than those in the T3 and T4 groups (P < .05).

Conclusion: A thermally softened DLT shortened the time to intubation, reduced the IR, improved the success rate of the first attempt at endotracheal intubation, and lowered the incidence of postoperative glottic injury and hoarseness. The optimal tube temperature for FOB-guided intubation of thermally softened DLT was 40 ± 1°C.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Bronchoscopes
  • Bronchoscopy* / adverse effects
  • Bronchoscopy* / instrumentation
  • Hoarseness / epidemiology
  • Humans
  • Intubation, Intratracheal* / adverse effects
  • Intubation, Intratracheal* / methods
  • Temperature