Predicting the size of the double-lumen tube in Asian women using ultrasound: A randomized controlled trial

Abstract

Abstract Background Asian women are often faced with difficult intubation with double-lumen tube (DLT). Previous studies have illustrated that cricoid and left main bronchus diameter together can predict the DLT size better, but it will take extra computed tomography (CT) scans for the patients. We hypothesized that predicting the best-fit left double-lumen tubes (LDLTs) size, ultrasound will show better efficacy than CT without increasing intubating complications for Asian women. Methods Our study enrolled 152 female patients undergoing elective thoracic surgery between March 2021 to October 2021. Patients were randomized into two groups: 75 in ultrasound group and 77 in the computed-tomography group. Patients in ultrasound group (US group) chosen the LDLT size according to the transverse diameter of the cricoid cartilage measured by ultrasound (TD-US). Controlled group based on the equivalent diameter of the left main bronchus (ED-LMB) measured by airway rebuilding of the helix CT (CT group). Results The overall accuracy of LDLT was compared. The proportion of the appropriate DLTs was similar between two groups (78.7 vs. 67.5%, P =0.161). The number of inappropriate cases in CT group increased when height of Asian women is under 160 cm (P <0.05). US group showed less resistance to pass the glottis (P <0.001) and took shorter time in intubating (P =0.002). Conclusion: Using ultrasound alone to select LDLT size has higher accuracy among Asian women less than 160 cm compared with CT. Trial registration Chictr.org.cn, registration number: ChiCTR2100043764