Operative lung deflation during lung deflation during one-lung ventilation (OLV) with a double-lumen endotracheal tube (DL-ETT) is faster when the operative lumen remains closed before pleural opening thus preventing it from entraining ambient air during the closed chest phase of OLV.

The median [interquartile range] time to lung deflation occurred faster in the intervention group than in the control group (24 [20–37] min vs 54 [48–68] min, respectively; median difference, 30 min; 95% confidence interval [CI], 14 to 46; P < 0.001). The estimated T50 was 32.6 min in the intervention group compared with 62.3 min in the control group (difference, − 29.7 min; 95% CI, − 51.1 to − 8.4; P = 0.008). 30 patients undergoing video-assisted thoracoscopic surgery (VATS) using DL-ETT to allow OLV were randomized to having the lumen of the operative lung either open (control group) or occluded (intervention group) to ambient air.

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