Surgery Clinical Trial
Official title:
Interest of Pleuropulmonary Ultrasound Associate With Clinical Examination to Check the Good Position of the Double Lumen Tube Intubation in Patients Undergoing Thoracic Surgery
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%.
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.
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