Ultrasound vs. Auscultation and Fiberoptic Bronchoscopy for Double-Lumen Tube Placement

Ultrasonographic Confirmation of Double-Lumen Endobronchial Tube Placement Compared With Auscultation and Fiberoptic Bronchoscopy in Thoracic Surgery: A Prospective Observational Study

One-lung ventilation is frequently required in thoracic surgery and is most commonly achieved using double-lumen endobronchial tubes (DLTs). Correct positioning of the DLT is crucial for effective lung isolation and patient safety. Fiberoptic bronchoscopy (FOB) is considered the gold standard for confirming DLT placement; however, it may not always be immediately available and requires specific expertise.

Lung ultrasonography is a rapid, noninvasive, and bedside imaging method increasingly used in anesthesiology and critical care. This prospective observational study aims to evaluate the diagnostic performance of lung ultrasound in confirming the correct position of double-lumen endobronchial tubes in patients undergoing thoracic surgery.

The results obtained from lung ultrasound will be compared with auscultation findings and fiberoptic bronchoscopy results. Fiberoptic bronchoscopy will be considered the reference standard. The sensitivity, specificity, positive predictive value, and negative predictive value of lung ultrasound and auscultation will be calculated.

Inclusion Criteria:

• Age between 18 and 65 years
• Scheduled for elective thoracic surgery
• Planned one-lung ventilation
• Use of double-lumen endobronchial tube
• ASA physical status I-III
• Written informed consent obtained

Exclusion Criteria:

• Known airway anomalies
• Previous lung resection surgery
• Tracheostomy
• Coagulopathy
• Pleural effusion or pleural pathology that may interfere with lung ultrasound evaluation
• Chest wall deformity
• Emergency surgery
• Patients who decline participation