Cadaveric evaluation of fluoroscopy-assisted placement of one-lung ventilation devices for video-assisted thoracoscopic surgery in dogs

Philipp D. Mayhew, Amandeep Chohan, Brian T. Hardy, Ameet Singh, J. Brad Case, Michelle A. Giuffrida, William T.N. Culp

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the feasibility of fluoroscopy-assisted placement of one-lung ventilation (OLV) devices in dogs. Study design: Experimental study. Sample population: Canine cadavers (n = 8) weighing between 20.2 and 37.4 kg. Methods: Thoracoscopic access with a two-port approach was established to evaluate bilateral lung ventilation patterns. Advancement of a left-sided Robertshaw double-lumen endobronchial tube (DLT) and the EZ-blocker (EZ) were evaluated under direct fluoroscopic guidance. Each dog also underwent bronchoscopy-assisted placement of an Arndt endobronchial blocker (EBB). Time to initial placement, success of creating complete OLV (after initial placement attempt and after up to two repositionings), and ease of placement score were recorded. Device position was evaluated bronchoscopically after each fluoroscopy-assisted placement attempt. Results: Time to initial placement was significantly shorter for EZ than for DLT and EBB. The rate of successful placement after up to two repositioning attempts was 87.5%, 87.5%, and 100.0% on the right and 87.5%, 100.0%, 100.0% on the left for DLT, EZ, and EBB, respectively, and was not different between devices. Ease of placement scores were significantly higher for DLT compared with EZ and EBB on both the left and the right sides. Conclusion: Fluoroscopy-assisted placement of DLT and EZ appears feasible in canine cadavers. EZ-blocker placement was efficient and technically easier than DLT, but positioning must be adapted for dogs. Bronchoscopy-assisted placement of EBB remains highly successful. Clinical significance: Fluoroscopy-assisted placement of EZ and DLT is a useful alternative to bronchoscopy-assisted placement of these OLV devices.

Original languageEnglish (US)
JournalVeterinary Surgery
DOIs
StateAccepted/In press - Jan 1 2019

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thoracoscopy
One-Lung Ventilation
Video-Assisted Thoracic Surgery
Fluoroscopy
breathing
bronchoscopy
Bronchoscopy
Dogs
Equipment and Supplies
dogs
Cadaver
Canidae
Ventilation
Research Design
Lung
experimental design
Population

ASJC Scopus subject areas

  • veterinary(all)

Cite this

@article{e448df6d2a4148c18e515486d3f01e9c,
title = "Cadaveric evaluation of fluoroscopy-assisted placement of one-lung ventilation devices for video-assisted thoracoscopic surgery in dogs",
abstract = "Objective: To evaluate the feasibility of fluoroscopy-assisted placement of one-lung ventilation (OLV) devices in dogs. Study design: Experimental study. Sample population: Canine cadavers (n = 8) weighing between 20.2 and 37.4 kg. Methods: Thoracoscopic access with a two-port approach was established to evaluate bilateral lung ventilation patterns. Advancement of a left-sided Robertshaw double-lumen endobronchial tube (DLT) and the EZ-blocker (EZ) were evaluated under direct fluoroscopic guidance. Each dog also underwent bronchoscopy-assisted placement of an Arndt endobronchial blocker (EBB). Time to initial placement, success of creating complete OLV (after initial placement attempt and after up to two repositionings), and ease of placement score were recorded. Device position was evaluated bronchoscopically after each fluoroscopy-assisted placement attempt. Results: Time to initial placement was significantly shorter for EZ than for DLT and EBB. The rate of successful placement after up to two repositioning attempts was 87.5{\%}, 87.5{\%}, and 100.0{\%} on the right and 87.5{\%}, 100.0{\%}, 100.0{\%} on the left for DLT, EZ, and EBB, respectively, and was not different between devices. Ease of placement scores were significantly higher for DLT compared with EZ and EBB on both the left and the right sides. Conclusion: Fluoroscopy-assisted placement of DLT and EZ appears feasible in canine cadavers. EZ-blocker placement was efficient and technically easier than DLT, but positioning must be adapted for dogs. Bronchoscopy-assisted placement of EBB remains highly successful. Clinical significance: Fluoroscopy-assisted placement of EZ and DLT is a useful alternative to bronchoscopy-assisted placement of these OLV devices.",
author = "Mayhew, {Philipp D.} and Amandeep Chohan and Hardy, {Brian T.} and Ameet Singh and Case, {J. Brad} and Giuffrida, {Michelle A.} and Culp, {William T.N.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/vsu.13331",
language = "English (US)",
journal = "Veterinary Surgery",
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T1 - Cadaveric evaluation of fluoroscopy-assisted placement of one-lung ventilation devices for video-assisted thoracoscopic surgery in dogs

AU - Mayhew, Philipp D.

AU - Chohan, Amandeep

AU - Hardy, Brian T.

AU - Singh, Ameet

AU - Case, J. Brad

AU - Giuffrida, Michelle A.

AU - Culp, William T.N.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To evaluate the feasibility of fluoroscopy-assisted placement of one-lung ventilation (OLV) devices in dogs. Study design: Experimental study. Sample population: Canine cadavers (n = 8) weighing between 20.2 and 37.4 kg. Methods: Thoracoscopic access with a two-port approach was established to evaluate bilateral lung ventilation patterns. Advancement of a left-sided Robertshaw double-lumen endobronchial tube (DLT) and the EZ-blocker (EZ) were evaluated under direct fluoroscopic guidance. Each dog also underwent bronchoscopy-assisted placement of an Arndt endobronchial blocker (EBB). Time to initial placement, success of creating complete OLV (after initial placement attempt and after up to two repositionings), and ease of placement score were recorded. Device position was evaluated bronchoscopically after each fluoroscopy-assisted placement attempt. Results: Time to initial placement was significantly shorter for EZ than for DLT and EBB. The rate of successful placement after up to two repositioning attempts was 87.5%, 87.5%, and 100.0% on the right and 87.5%, 100.0%, 100.0% on the left for DLT, EZ, and EBB, respectively, and was not different between devices. Ease of placement scores were significantly higher for DLT compared with EZ and EBB on both the left and the right sides. Conclusion: Fluoroscopy-assisted placement of DLT and EZ appears feasible in canine cadavers. EZ-blocker placement was efficient and technically easier than DLT, but positioning must be adapted for dogs. Bronchoscopy-assisted placement of EBB remains highly successful. Clinical significance: Fluoroscopy-assisted placement of EZ and DLT is a useful alternative to bronchoscopy-assisted placement of these OLV devices.

AB - Objective: To evaluate the feasibility of fluoroscopy-assisted placement of one-lung ventilation (OLV) devices in dogs. Study design: Experimental study. Sample population: Canine cadavers (n = 8) weighing between 20.2 and 37.4 kg. Methods: Thoracoscopic access with a two-port approach was established to evaluate bilateral lung ventilation patterns. Advancement of a left-sided Robertshaw double-lumen endobronchial tube (DLT) and the EZ-blocker (EZ) were evaluated under direct fluoroscopic guidance. Each dog also underwent bronchoscopy-assisted placement of an Arndt endobronchial blocker (EBB). Time to initial placement, success of creating complete OLV (after initial placement attempt and after up to two repositionings), and ease of placement score were recorded. Device position was evaluated bronchoscopically after each fluoroscopy-assisted placement attempt. Results: Time to initial placement was significantly shorter for EZ than for DLT and EBB. The rate of successful placement after up to two repositioning attempts was 87.5%, 87.5%, and 100.0% on the right and 87.5%, 100.0%, 100.0% on the left for DLT, EZ, and EBB, respectively, and was not different between devices. Ease of placement scores were significantly higher for DLT compared with EZ and EBB on both the left and the right sides. Conclusion: Fluoroscopy-assisted placement of DLT and EZ appears feasible in canine cadavers. EZ-blocker placement was efficient and technically easier than DLT, but positioning must be adapted for dogs. Bronchoscopy-assisted placement of EBB remains highly successful. Clinical significance: Fluoroscopy-assisted placement of EZ and DLT is a useful alternative to bronchoscopy-assisted placement of these OLV devices.

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