{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:28:32Z","timestamp":1787228912818,"version":"build-2736575974"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>One-lung ventilation (OLV) is essential in thoracic anesthesia and is commonly achieved using double-lumen tubes or bronchial blockers (BBs). Recent visualization-integrated systems, such as VivaSight\u2122, may improve procedural efficiency and safety, particularly for clinicians with limited BB experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A preclinical simulation-based evaluation was conducted in a randomized crossover design using two experimental simulation models. In the first experimental model, a randomized crossover simulation manikin study was conducted that involved 21 anesthesiologists with minimal BB experience, comparing two BB-based lung isolation strategies: a visualization-integrated approach using VivaSight-EB\u2122 and a conventional approach using EZ-Blocker\u2122 with bronchoscopic guidance. In addition, the second experimental model involved a mixed-model randomized crossover simulation study that evaluated procedural workflow, operator experience, and cost-related outcomes. Twenty anesthesiologists with experience in lung-isolation performed two BB-based lung isolation strategies: blind placement of the EZ-Blocker\u2122 and placement of the EZ-Blocker\u2122 through a VivaSight\u2122 single-lumen endotracheal tube. The primary outcome in the two simulation-based experiments was time to achieve left-lung exclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the simulation manikin experiment, 21 anesthesiologists with limited experience in lung isolation were involved and the visualization-integrated strategy achieved significantly faster left-lung exclusion compared with the conventional approach (32.1 \u00b1 5.3 s vs 134.8 \u00b1 56.6 s;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). While in the mixed-model simulation experiment, 20 thoracic anesthesiologists with experience in lung-isolation techniques were involved and similar time advantages were observed, favoring the visualization-integrated strategy (34.6 \u00b1 8.1 s vs 68.5 \u00b1 19.5 s). Moreover, secondary outcomes consistently favored the visualization-integrated strategy, including higher operator satisfaction, fewer procedural failures, and lower procedure-related costs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The VivaSight-EB\u2122 system demonstrated superior efficiency and workflow performance across both simulation environments. These findings support the potential clinical advantage of integrated visualization systems, particularly for operators with limited BB experience, and warrant further clinical evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_263_26","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:00:51Z","timestamp":1782968451000},"page":"608-614","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic control for bronchial blockers: Experimental evaluation of single-lung ventilation strategies in simulation-based models"],"prefix":"10.4103","volume":"20","author":[{"given":"Hussam","family":"Rajhi","sequence":"first","affiliation":[{"name":"Division of Anesthesiology, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia"},{"name":"Department of Anesthesiology, CHU Strasbourg, University of Strasbourg, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"R1-20260820","first-page":"441","article-title":"Sore throat or hoarse voice with bronchial blockers or double-lumen tubes for lung isolation: A randomised, prospective trial","volume":"37","author":"Zhong","year":"2009","journal-title":"Anaesth Intensive Care"},{"key":"R2-20260820","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1097\/00000542-200609000-00009","article-title":"Airway injuries after one-lung ventilation: A comparison between double-lumen tube and endobronchial blocker: A randomized, prospective, controlled trial","volume":"105","author":"Knoll","year":"2006","journal-title":"Anesthesiology"},{"key":"R3-20260820","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1053\/j.jvca.2009.05.014","article-title":"The use of bronchial blockers for providing one-lung ventilation","volume":"23","author":"Neustein","year":"2009","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R4-20260820","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12871-018-0677-3","article-title":"VivaSight\u2122single-lumen tube guided bronchial blocker placement for one-lung ventilation in a patient with a tracheal tumor under video-assisted transthoracic surgery: A case report","volume":"19","author":"Qiu","year":"2019","journal-title":"BMC Anesthesiol"},{"key":"R5-20260820","doi-asserted-by":"crossref","first-page":"e068071","DOI":"10.1136\/bmjopen-2022-068071","article-title":"Effect of the VivaSight double-lumen tube on the incidence of hypoxaemia during one-lung ventilation in patients undergoing thoracoscopic surgery: A study protocol for a prospective randomised controlled trial","volume":"13","author":"Long","year":"2023","journal-title":"BMJ Open"},{"key":"R6-20260820","doi-asserted-by":"crossref","first-page":"30","DOI":"10.5603\/DEMJ.a2020.0011","article-title":"VivaSight single-lumen tube as an intubation method. A systematic review and meta-analysis of randomised simulation trials","volume":"5","author":"Karczewska","year":"2020","journal-title":"Disaster Emerg Med J"},{"key":"R7-20260820","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1053\/j.jvca.2023.06.015","article-title":"A practical guide for using the EZ-blocker endobronchial blocker: Tips and tricks after 10 years of experience","volume":"37","author":"Rispoli","year":"2023","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R8-20260820","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.3390\/jcm12051877","article-title":"Systematic review and meta-analysis of efficiency and safety of double-lumen tube and bronchial blocker for one-lung ventilation","volume":"12","author":"Palaczynski","year":"2023","journal-title":"J Clin Med"},{"key":"R9-20260820","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1053\/j.jvca.2017.07.026","article-title":"Bronchial blocker versus left double-lumen endotracheal tube for one-lung ventilation in right video-assisted thoracoscopic surgery","volume":"32","author":"Lu","year":"2018","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R10-20260820","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jclinane.2016.04.034","article-title":"VivaSight: A new era in the evolution of tracheal tubes","volume":"33","author":"Saracoglu","year":"2016","journal-title":"J Clin Anesth"},{"issue":"(Suppl. 1 to No. 7-8)","key":"R11-20260820","first-page":"1","article-title":"Usefulness of ETView TVT endotracheal tube for correct positioning of bronchial blockers in left lobectomy: An easy and safe combination","volume":"75","author":"Giglio","year":"2009","journal-title":"Minerva Anestesiol"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_263_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:01:17Z","timestamp":1787227277000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_263_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_263_26","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-03-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}