Comparison of clinical characteristics of different ventilation devices for one-lung ventilation in adults: a network meta-analysis.

Abstract

Objectives: Different ventilation devices, including double-lumen tube (DLT), video DLT (VDLT), and various bronchial blockers (BBs), were used for one-lung ventilation (OLV). This study aimed to assess the clinical characteristics of 12 OLV devices to identify the optimal ventilation strategy for different situations.

Methods: PubMed, Embase, Web of Science, and the Cochrane Library were searched following the PICOS principle to retrieve relevant randomized controlled trials (RCTs) up to 18 November 2023. Network meta-analysis was conducted using R 4.3.2, StataSE15, and Review Manager 5.3 software to compare the clinical characteristics of these OLV devices, including the quality of lung collapse, malposition rate, time for device placement, the success of the first intubation attempt, postoperative sore throat, and hoarseness.

Results: In summary, this study involved 33 RCTs with a total of 2177 patients to evaluate the clinical characteristics of 12 ventilation devices. Compared to the Arndt BB, DLT provided higher lung collapse quality and was less prone to malposition. According to the Ranking probabilities, the VDLT had a shorter placement time, while the Coopdech BB (CBB) had a higher success rate on the first intubation attempt. The Cohen Flex-Tip BB resulted in less hoarseness, and the CBB had a lower incidence of sore throat.

Conclusion: DLT demonstrated reliable lung collapse quality. VDLT allowed for quicker placement and continuous airway monitoring. BBs had fewer complications and were easier to place but had a higher risk of malposition. Therefore, choosing an OLV device depends on the patient's clinical status and surgical needs.