2. Department of Pulmonary and Critical Care Medicine at the University of Texas Health Science Center at San Antonio & South Texas Veterans Health Care System, USA.
Objective: Our aim was to compare the efficacy of silicone spray (SS) to water soluble lubricating jelly (WSLJ) as an aid to fiberoptic bronchoscopy, according to time of bronchoscopy, shear forces measured via the endotracheal tube cuff, cost, and survey satisfaction.
Study design: Randomized, crossover experimental design.
Materials & Methods: We evaluated 19 clinicians performing bronchoscopy on a simulation pulmonary model, after receiving informed consent. Half of the volunteers were randomized to begin the experiment at either the SS or WSLJ manikin, and then crossed over. Volunteers performed bronchoscopy and silently read the message at the end of each mainstem bronchus. Outcomes were evaluated based on time to perform the bronchoscopic exam and peak airway pressure/shear forces, cost, and survey satisfaction defined as quality of view and ease of lubricant use for bronchoscopy.
Results: There were no differences in time (p=0.1), or peak airway pressure between SS and WSLJ bronchoscopic exams (p=0.7). When questioned about quality of bronchoscopic view, 12 subjects ranked SS as having higher quality view than the WSLJ manikin, and the paired rankings were significantly different by Wilcoxon signed-ranks test (p=0.02). Combined view quality and ease of use scores favored SS for 13 volunteers, and the paired rankings were significantly different (p=0.03).
Conclusions: Although we were unable to identify superiority between these two lubricants based on variables of time and peak pressure, we did identify improved quality of view with SS. In practical use, it is likely that clinicians would prefer SS to WSLJ.
Keywords: Bronchoscopy, lubricant, silicone spray, lubricant jelly, airway management, simulation