VivaSight Double-Lumen Tube Versus Conventional Double-Lumen Tube for One-Lung Ventilation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract

The main objective of this systematic review and meta-analysis was to determine the safety and effectiveness of VivaSight double-lumen tubes (VS-DLTs) in one-lung ventilation (OLV) compared to conventional DLTs (c-DLTs). The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement's guidelines. From the database's inception to December 2022, we searched seven different databases. We included 364 patients from six randomized controlled trials who were scheduled to undergo surgery requiring OLV. The Cochrane risk of bias assessment tool was utilized to determine the risk of bias. The odds ratio (OR) was estimated for categorical variables, while the mean difference was calculated for continuous variables. Patients were randomly assigned to the VS-DLT or c-DLT group. The results revealed that patients in the c-DLT group have longer intubation time than the VS-DLT patients (mean difference [MD] = -90.01; 95% confidence interval [CI], -161.33 to -18.69; P = 0.01). Significantly, more secretions were present in the VS-DLT group than in the c-DLT group (OR = 4.24; CI, 1.96 to 9.13; P = 0.0002). Also, the fiberoptic bronchoscope was used more frequently in the c-DLT group compared to the VS-DLT group (OR = 0.01 [0.00, 0.07]; P < 0.00001). We found that VS-DLT was safe as the pooled analysis showed no significant difference according to side effects such as hoarseness and sore throat. The other outcomes, such as dislodgement, the clearance of secretions, and the quality of lung deflation (excellent), were non-significant between the two groups.