Pleuropulmonary Ultrasound With Clinical Examination to Check the Good Position of the Double Lumen Tube Intubation (Echo-Thorax)

Association Pro-arte

Status: Completed

Conditions: Thoracic; Surgery

Treatments: Diagnostic Test: Pleuropulmonary ultrasound with clinical examination

Study type: Interventional

Funder types: Other

Identifiers

NCT03836183

3-2018-EchoThorax

Details and patient eligibility

About

Using a new ultrasound approach, allow us to avoid the systematic use of bronchoscopy which is an invasive procedure. Although rare, several complications are known with, among other things, the occurrence of pulmonary infections, pneumothorax associated with increased pressure in the airways, atelectasis or bronchospasm.

Avoid the systematic control by fibroscopy in simple cases which makes it possible to overcome the complications related to its use and its cost.

The investigators want to evaluate the diagnostic value of the echographic strategy in 2 steps (2D and TM) on 3 sections (pulmonary field on the axillary line of the 2 sides and left upper lobe) associated with the clinical examination in preoperative by comparing with the gold standard: fibroscopy. Clinical examination and pleuropulmonary ultrasound should have a positive predictive value of at least 85%.

Full description

In thoracic surgery, it is common to use selective intubation probes to exclude from ventilation the lung operated by the surgeon. It is recommended to perform a bronchoscopy which is the reference examination to confirm the good position of these probes. The interest of systematically controlling the good position of the left selective intubation probe by fibroscopy is controversial.

The interest of ultrasound for the diagnosis of pleuro-pulmonary pathologies is certain in resuscitation and emergency context for the diagnosis of pneumothorax, haemothorax and atelectasis.

The use of pleuropulmonary ultrasound in anesthesiology is the subject of studies. Several teams used it to ensure proper endotracheal tube positioning and to diagnose selective intubation. In fact, it has been shown that to control the position of the probe more precisely, ultrasound is more efficient than auscultation.

The aim of this work is to show by a large-scale prospective study that pleuropulmonary ultrasound associated with the clinical examination confirms the exclusion of the operated lung. the absence of systematic control of the positioning of the probe by fibroscopy allow financial gain and a reduction in the risk of morbidity related to the realization of this invasive gesture.

Enrollment: 70 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient will benefit from thoracic or cardiac surgery requiring selective left intubation.
• Affiliation to the French social security

Exclusion criteria

• Minor patients
• Refusal of the patient
• Patients under guardianship, curators.
• Surgery not compatible with a visualization of the pleural slip in echography: surgery of pneumothorax or liquid effusion
• History likely to disturb the detection of pleural slip on ultrasound: pneumothorax surgery
• Predictable intubation difficulties and the need for selective bronchial blocker intubation
• Pregnant or lactating women

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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70 participants in 1 patient group

ultrasound

Other group

Description:

* ultrasound is the only study group for all the patients * pleuropulmonary ultrasound * clinical examination * fibroscopy.

Treatment:

Diagnostic Test: Pleuropulmonary ultrasound with clinical examination