Error traps in pediatric one‐lung ventilation

Lazar, Alina; Chatterjee, Debnath; Templeton, T. Wesley

doi:10.1111/pan.14333

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…However, utility of these devices is limited by certain factors like nonavailability in pediatric sizes, requirement of flexible bronchoscope, and lastly the expertise of the operator. 2,3 Therefore, this index case showcases an innovative technique for lung insolation which is relatively easy and can be of great utility especially in resource limited settings.…”

Section: Sirmentioning

confidence: 99%

An innovative technique for lung isolation in pediatric patient: Another arrow in the quiver!

Patel,

Tripta,

Choudhary

et al. 2023

Pediatric Anesthesia

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Section: Sirmentioning

confidence: 99%

An innovative technique for lung isolation in pediatric patient: Another arrow in the quiver!

Patel,

Tripta,

Choudhary

et al. 2023

Pediatric Anesthesia

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“…Ultrasound is also virtually ubiquitous in pediatric ORs and can be used pre-, intra-, and post-operatively to detect atelectasis at the bedside [ 60 ]. Endobronchial blockers are available in sizes that fit a few-month-old patient, allowing safe single lung ventilation in minimally invasive thoracic surgery [ 61 ]. Continuous monitoring of neuromuscular relaxation allows surgery and successive extubation with minimal risk for postoperative pulmonary complications [ 62 ].…”

Section: Pediatric Anesthesia During Masmentioning

confidence: 99%

Minimal Access in Pediatric Surgery: An Overview on Progress towards Dedicated Instrument Developments and Anesthesiologic Advances to Enhance Safe Completion of Procedures

Pelizzo,

Destro,

Pierucci

et al. 2024

Children

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Surgical techniques are evolving in Pediatric Surgery, especially in the area of minimal access surgery (MAS) where indications for applications are expanding. Miniaturization of instruments, using natural orifices, single incisions, or remotely controlled robot-assisted procedures, promises to increase the benefits of MAS procedures in pediatrics. Many pediatric pathologies are rare, and specialized surgical and anesthesiologic instruments are necessary to manage them, defined as “orphan devices”, for which development and dissemination on the market are slowed down or sometimes hindered by regulatory standards and limiting financial conflicts of interest. In pediatric surgery, it is of utmost importance to work in a multidisciplinary way to offer a surgical path that is safe and supported by technological advances. For this reason, optimizing pediatric anesthesia is also a crucial factor where technological advances have made monitoring more precise, thereby enhancing safety in the operative room. The development of customized instruments and technologies should be supported by pediatric research and should be adapted to the individualities of the small patient. This overview outlines the importance of dedicated instruments developed for the safe completion of MAS procedures in pediatrics.

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“…One lung ventilation is commonly used in thoracic procedures [ 1 ], especially in children undergoing surgeries for congenital heart diseases. Proper fluid management is crucial during OLV to avoid pulmonary edema, especially considering the narrow fluid tolerance in pediatric patients with congenital heart disease (CHD).…”

Section: Introductionmentioning

confidence: 99%

The Hemodynamic Changes Induced by Lung Recruitment Maneuver to Predict Fluid Responsiveness in Children during One Lung Ventilation—A Prospective Observational Study

Liu,

He,

et al. 2024

Children

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Background: The prediction of fluid responsiveness in critical patients helps clinicians in decision making to avoid either under- or overloading of fluid. This study was designed to determine whether lung recruitment maneuver (LRM) would have an effect on the predictability of fluid responsiveness by the changes of hemodynamic parameters in pediatric patients who were receiving lung-protective ventilation and one-lung ventilation (OLV). Methods: A total of 34 children, aged 1–6 years old, scheduled for heart surgeries via right thoracotomy were enrolled. Patients were anesthetized and OLV with lung-protection ventilation settings was established, and then, positioned on left lateral decubitus. LRM and volume expansion (VE) were performed in sequence. Heart rate (HR), systolic arterial pressure (SAP), mean arterial pressure (MAP) diastolic arterial pressure (DAP), stroke volume (SV), stroke volume variation (SVV), and pulse pressure variation (PPV) were recorded via an A-line based monitor system at the following time points: before and after LRM (T1 and T2) and before and after VE (T3 and T4). An increase in stroke volume (SV) or mean arterial pressure (MAP) of ≥10% following fluid loading identified fluid responders. The predictability of fluid responsiveness by the changes of SV (ΔSVLRM) and MAP (ΔMAPLRM) after LRM and VE were statistically evaluated by receiver operating characteristic curves [area under the curves (AUC)]. Results: SVs in all patients were significantly decreased after LRM (p < 0.01) and then, increased and returned to baseline after VE (p < 0.01). In total, 16 out of 34 patients who were fluid responders had significantly lower SV after LRM compared to that in fluid non-responders. The area under the receiver operating characteristic curves for ΔSVLRM was 0.828 (95% confidence interval [CI], 0.660 to 0.935; p < 0.001) and it indicated that ΔSVLRM was able to predict the fluid responsiveness of pediatric patients. MAPs in all patients were also decreased significantly after LRM, and 12 of them fell into the category of fluid responders after VE. Statistically, ΔMAPLRM did not predict fluid responsiveness when LRM was considered as an influential factor (p = 0.07). Conclusions: ΔSVLRM, but not ΔMAPLRM, showed great reliability in the prediction of the fluid responsiveness following VE in children during one-lung ventilation with lung-protective settings. Trial registration: ChiCTR2300070690.

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Error traps in pediatric one‐lung ventilation

Cited by 8 publications

References 23 publications

An innovative technique for lung isolation in pediatric patient: Another arrow in the quiver!

An innovative technique for lung isolation in pediatric patient: Another arrow in the quiver!

Minimal Access in Pediatric Surgery: An Overview on Progress towards Dedicated Instrument Developments and Anesthesiologic Advances to Enhance Safe Completion of Procedures

The Hemodynamic Changes Induced by Lung Recruitment Maneuver to Predict Fluid Responsiveness in Children during One Lung Ventilation—A Prospective Observational Study

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