Selective lung intubation during paediatric thoracic surgeries

Abstract

Selective lung intubation is a necessary prerequisite for the completion of most interventions comprising thoracotomy and thoracoscopy. In paediatric care, our site uses Univent tubes for children up to the age of three years and double-lumen tubes (DLT) for children from 6-8 years of age. In younger children, we usually use regular endotracheal intubation, with the lung being held in the hemithorax position being operated on using a surgical retractor. The article presents the analysis of 860 thoracic surgeries, of which 491 comprised selective intubation (Univent 57 cases, DLT 434 cases). The use of the aforementioned devices is connected with certain complications. Univent tube can be connected with intraoperative dislocation of the obturating balloon (29.8%) and balloon perforation (5.2%). DLT insertion may be connected with failure of tube fi tting. In 84 cases we had to repeat DLT insertion (20.6%). In 8 cases we were not able to insert DLT at all (1.8%). Standard use of selective intubation methods in paediatric patients from two years of age improved the conditions for surgical interventions (Tab. 2, Fig. 2, Ref. 19).

Is Bilateral Staged Muscle-Sparing Thoracotomy Performed within 1 Week for Lung Hydatid Cysts Safe for Pediatric Patients?

“…Blood or cyst fluid leakage into the bronchial system can be seen as edema and atelectasis in the postoperative chest X-rays. Double lumen intuba- tion is very effective to prevent this condition [20]. It is also necessary to aspirate the cyst cavity frequently during surgery and provide positive ventilation before thoracotomy closure.…”