Dimensional compatibility of balloon‐tipped bronchial blockers with the pediatric airway anatomy using different recommendations for age‐related size selection

Goetschi, Markus; Kemper, M.; Kleine‐Brueggeney, Maren; Henze, Georg; Weiß, Markus

doi:10.1111/pan.13973

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…Als Alternative können Bronchusblocker (z. B. Arndt-Blocker oder Fogarty-Katheter) eingesetzt werden, die zurzeit aber nicht mit Hochvolumen-Niederdruck-Blockermanschetten verfügbar sind 23 , 24 .…”

Section: Diskussionunclassified

Fallberichte: Kinder mit tracheoösophagealer Fistel nach Knopfbatterieningestion

Keil¹,

Avşar²,

Beck³

et al. 2022

Anästhesiol Intensivmed Notfallmed Schmerzther

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ZusammenfassungFremdkörperingestionen bei Kindern nehmen stetig zu – dabei werden u. a. Knopfbatterien sehr häufig verschluckt. Das weitverbreitete Modell CR2032 führt bereits nach kurzer Zeit zu schweren Laugenverätzungen mit möglicher Perforation in benachbarte Organe. Dieser Fallserienbericht stellt 4 Kinder vor, die nach Ingestion von Knopfbatterien eine tracheoösophageale Fistel entwickelten und in unserer Kinderklinik interdisziplinär versorgt wurden.

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Section: Diskussionunclassified

Fallberichte: Kinder mit tracheoösophagealer Fistel nach Knopfbatterieningestion

Keil¹,

Avşar²,

Beck³

et al. 2022

Anästhesiol Intensivmed Notfallmed Schmerzther

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“…2,9 Maximum recommended inflation volumes of air and related resulting expected balloon diameters as provided by the manufacturers are summarized for each size and both brands of blocker balloons in Table1. 10…”

Section: Me Thodsmentioning

confidence: 99%

Inflation volume‐balloon diameter and inflation pressure‐balloon diameter characteristics of commonly used bronchial blocker balloons for single‐lung ventilation in children

Goetschi

Kemper

Kleine‐Brueggeney

et al. 2021

Pediatric Anesthesia

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Background: Balloon-tipped bronchial blocker catheters are widely used in pediatric thoracic anesthesia to establish single-lung ventilation. In clinical practice, their balloons demonstrate sudden expansion when inflated with air. In addition, there are concerns related to the high inflation pressures required to expand the balloons. Methods: This in vitro study assessed inflation volume-and inflation pressure-balloon diameter characteristics of the Fogarty arterial embolectomy catheters and Arndt endobronchial blockers. Balloon diameters were photographically assessed during unrestricted volume-and pressure-guided inflation, using air up to the maximum allowed inflation volume as indicated by the manufacturers. Inflation pressures required to open the blocker balloons and inflation pressures needed to expand them to maximum indicated diameter were measured. Results: Volume-guided inflation demonstrated a late acute rise in diameter in Fogarty blocker balloons, whereas in the Arndt endobronchial blocker balloons almost linear inflation volume-to-diameter characteristics were observed. Pressure-guided inflation on the other hand demonstrated low-volume, high-pressure characteristics in the Fogarty blocker balloons, with inflation pressures required to expand the balloons to maximum diameters ranging from (mean (SD)) 636 (75) to 947 (152) cmH 2 O. The inflation pressures required to open the Fogarty blocker balloons were even >1000 cmH 2 O. Inflation pressures required to expand the 5 F, 7 F, and 9 F Arndt endobronchial blocker balloons to maximum indicated diameter were much lower, namely at 218 (15), 252 (28), and 163 (8) cmH 2 O. Conclusion: Based on these study findings, the balloons of Fogarty arterial embolectomy catheters represent high-pressure devices and do not permit stepwise controlled bronchial blockage. The Arndt endobronchial blockers have some advantages over the Fogarty blocker devices, but also represent high-pressure equipment and must be used with caution and limited duration. Manufacturers are asked to design pediatric endobronchial blocker catheters with truly high-volume, low-pressure balloons in accordance to age-related pediatric airway dimensions.

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“…However, double-lumen endotracheal tubes suitable for children, especially for infants, are not available in the Chinese market. Endobronchial blocker (BB) placement is the preferred and most frequently used lung separation technique in children (6)(7)(8)(9). Due to the immaturity of organ development and the small body size of infants, the risk of lung separation in these children is higher than that in preschool-age or older children.…”

Section: Introductionmentioning

confidence: 99%

Application of laryngeal mask airway anesthesia with preserved spontaneous breathing in children undergoing video-assisted thoracic surgery

Huang

Zhang

et al. 2023

Front. Pediatr.

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PurposeTo investigate the feasibility and safety of non-intubated general anesthesia with spontaneous breathing combined with paravertebral nerve blocks (PVNB) in young children undergoing video-assisted thoracic surgery (VATS) and to determine its significance for rapid recovery after pediatric thoracic surgery.MethodsThe data of 46 children aged 6–36 months with an American Society of Anesthesiologists status of I–II who underwent elective VATS under general anesthesia were retrospectively analyzed. Of these patients, 25 underwent non-intubated general anesthesia with spontaneous breathing combined with PVNB (non-intubation group), and 21 received conventional intubated general anesthesia combined with local infiltration anesthesia (intubation group). The following perioperative parameters were compared between the two groups: heart rate (HR), mean arterial pressure, saturation of pulse oximetry (SpO2), partial pressure end-tidal carbon dioxide, time from the completion of the operation to extubation or removing laryngeal masks, time to first feeding after the operation, length of postoperative in-hospital stay, incidence of postoperative complications, and hospitalization expenses.ResultsThe operations were completed successfully in both groups. When the non-intubation group was compared with the intubation group, the minimal SpO2 level during the surgery was higher (93% vs. 88%, P < 0.001), which might indicate better oxygenation. There was no significant difference of the duration of surgery and intraoperative blood loss between two groups. Compared to the intubation group, the duration of anesthesia (P = 0.027), time from the completion of the operation to extubation (P < 0.001), time to the first feeding after surgery (P < 0.001), and length of postoperative in-hospital stay (P < 0.001) were significantly reduced in the non-intubation group. The incidence of postoperative complications was not significantly different.ConclusionsNon-intubated general anesthesia with spontaneous breathing combined with PVNB is safe and feasible in young children undergoing VATS and can promote rapid recovery in young children undergoing thoracoscopic surgery.

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Dimensional compatibility of balloon‐tipped bronchial blockers with the pediatric airway anatomy using different recommendations for age‐related size selection

Cited by 5 publications

References 19 publications

Fallberichte: Kinder mit tracheoösophagealer Fistel nach Knopfbatterieningestion

Fallberichte: Kinder mit tracheoösophagealer Fistel nach Knopfbatterieningestion

Inflation volume‐balloon diameter and inflation pressure‐balloon diameter characteristics of commonly used bronchial blocker balloons for single‐lung ventilation in children

Application of laryngeal mask airway anesthesia with preserved spontaneous breathing in children undergoing video-assisted thoracic surgery

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