ABSTRACT : to check whether accuracy of clinical methods can be improved by addition of USG in confirmation of left DLT (LDLT) position

METHODS : This was a single centred, prospective, stratified randomised controlled study involving 70 adult patients undergoing elective thoracic surgery requiring use of LDLT. Patients were assigned to group A- where LDLT position is judged by using clinical methods alone, and group B- where LDLT position is judged by USG in addition to clinical methods. Correct position was predicted when USG demonstrated lung pulse on right side and lung sliding on left side along with normal airway pressures and oxygenation parameters. Final confirmation about LDLT position was done by direct observation of lung isolation by a surgeon, as paediatric bronchoscope was unavailable during study time. Contingency table was drawn to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy.

RESULTS : Sensitivity (75% vs. 88%), specificity (18% vs. 75%), PPV, NPV and accuracy (57% vs. 85%) for correct prediction of LDLT position improved significantly in group B.

CONCLUSIONS : USG is a useful addition to the armamentarium of anaesthesiologist for the confirmation of LDLT position