A sterile, single-use double-lumen tube is more cost effective for one-lung ventilation procedures in thoracic surgeries than a conventional double-lumen tube with a reusable bronchoscope, potentially saving a hospital almost $30,000 annually.
That’s according to a new study in PharmacoEconomics-Open, a peer-reviewed Springer medical journal. The cost of using Ambu’s VivaSight-DL was $299.96 per procedure, compared with $347.61 for a conventional double-lumen tube with a reusable bronchoscope.
The study authors also found a significant reduction in bronchoscope use for OLV procedures, leading to increased patient safety and a better workflow. And any risk of cross contamination was eliminated since VivaSight-DL is a sterile, single-use product.
The study, funded by Ambu, was a randomized control trial conducted at a large university hospital in Denmark where about 600 one-lung ventilation (OLV) procedures are performed annually.
OLV is an essential part of most thoracic surgeries, and the most common method is intubation with a double-lumen tube, or DLT. Intubation and airway management during lung-isolation procedures, however, present a series of challenges for even the most experienced medical team. DLTs can be difficult to insert and often move when a patient’s body moves. This can compromise patient safety and prolong surgery time.
Visualization during OLV improves patient safety and is increasingly recommended as good clinical practice. Doctors check for correct tube placement using a fiber-optic or video-enabled bronchoscope, both after tube insertion and after changing the patient’s position to the final lateral surgical position. This, however, further increases the risk of the tube being displaced.
Visualization can ensure more accurate and safer tube placement, significantly reducing the number of failed intubations as well as the time spent verifying the tube’s placement. The VivaSight-DL is the only single-use DLT with an integrated camera, enabling a more accurate tube placement.
The study had 22 patients in the conventional DLT arm and 30 in the VivaSight-DL arm. The differences in the cost per procedure resulted in an annual saving of $28,600 for a hospital doing 600 OLV procedures if the single-use devices were substituted for conventional ones. And a bronchoscope was only needed in 6.6 percent of OLV cases when using VivaSight-DL. That resulted in an incremental cost-effectiveness ratio of -$51.06 per bronchoscopy avoided.
Reusable bronchoscopes, of course, come with their own costs—purchasing, reprocessing (involving high-level disinfection), and general maintenance and repair. These costs are expected to increase in the future as more hospitals conduct more procedures.
Since this study’s conclusions were based on the results from a single institution, further study is needed to clarify whether VivaSight-DL is cost effective in larger or global clinical settings, the authors write.