Abstract No.: ABS1268: A prospective interventional study to detect the efficacy of bronchial cuff pressure monitoring to detect the displacement of lung isolation device in elective thoracic surgeries.

BACKGROUND & AIMS: Dislodgement of double lumen tube (DLT) is known to occur during change of position of patient and also during the surgery. We conducted a single centre interventional study to find out the efficacy of continuous bronchial cuff pressure (BCP) monitoring to detect the DLT dislodgement. METHODS: After insertion of left sided DLT and confirmation of position by bronchoscopy by anesthesiologist, BCP was transduced using a pressure transducer. In the first part of the study, DLT was moved proximally and distally under bronchoscopic vision and BCP values were noted at each position. In case of pre-defined events like loss of lung isolation, drop in oxygenation, increase in peak airway pressure and change in BCP, bronchoscopy was performed by the anesthesiologist to note the position of DLT. RESULTS: Upon distal movement of DLT, increase in BCP was noted in 83% of cases (63/76). Upon distal movements of DLT, a drop in BCP was noted 84% of cases (64/76). During the second part of the study, predefined events occurred at 57 times. In these 57 events, the sensitivity, specificity, PPV and NPV of BCP monitoring to detect displacement of DLT was 100%, 9%, 66.1%, 100% respectively. CONCLUSION: Continuous BCP monitoring is a useful method to detect the displacement of left sided DLT during elective thoracic surgeries.