Severe desaturation while attempting one-lung ventilation for congenital cystic adenomatoid malformation with respiratory distress syndrome in neonate -A case report-

Seok, Ji Hye; Kim, Sang Hyun; Ban, Jong Seouk; Lee, Sang Gon; Lee, Ji‐Hyang; Seo, Da Mi; Shim, Kwang Seok

doi:10.4097/kjae.2013.65.1.80

Cited by 3 publications

(5 citation statements)

References 13 publications

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“…One-lung ventilation (OLV) is essential for lung surgery [ 1 , 2 ]. The major concerns in OLV for anesthesiologists are the prevention of hypoxemia during surgery and the prevention of acute lung injury (ALI), which is associated with high postoperative mortality and morbidity [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation

Song

Jung

Cho

et al. 2014

Korean J Anesthesiol

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BackgroundThe purpose of this study was to investigate the changes in airway pressure and arterial oxygenation between ventilation modes during one-lung ventilation (OLV) in patients undergoing thoracic surgery.MethodsWe enrolled 27 patients for thoracic surgery with OLV in the lateral decubitus position. The subjects received various modes of ventilation in random sequences during surgery, including volume-controlled ventilation (VCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) with a tidal volume (TV) of 8 ml/kg of actual body weight. Target-controlled infusion (TCI) with propofol and remifentanil was used for anesthesia induction and maintenance. After double-lumen endobronchial tube (DLT) insertion, the proper positioning of the DLT was assessed using a fiberoptic bronchoscope. Peak inspiratory pressure (Ppeak), exhaled TV, and arterial blood gas were measured 30 min after each ventilation mode.ResultsPpeak was significantly reduced with the PCV-VG mode (19.6 ± 2.5 cmH2O) compared with the VCV mode (23.2 ± 3.1 cmH2O) (P < 0.000). However, no difference in arterial oxygen tension was noted between the groups (PCV-VG, 375.8 ± 145.1 mmHg; VCV, 328.1 ± 123.7 mmHg) (P = 0.063). The exhaled TV was also significantly increased in PCV-VG compared with VCV (451.4 ± 85.4 vs. 443.9 ± 85.9 ml; P = 0.035).ConclusionsDuring OLV in patients with normal lung function, although PCV-VG did not provide significantly improved arterial oxygen tension compared with VCV, PCV-VG provided significantly attenuated airway pressure despite significantly increased exhaled TV compared with VCV.

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Section: Introductionmentioning

confidence: 99%

Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation

Song

Jung

Cho

et al. 2014

Korean J Anesthesiol

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“…Several techniques have been described for the extraluminal placement of Fogarty catheters (4,5). Extraluminal techniques, which require insertion of a Fogarty catheter into the trachea before intubating an endotracheal tube, require a long unventilated time, with an attendant risk of severe desaturation (6). When using the extraluminal technique, however, use of a Fogarty catheter is prone to mispositioning (5).…”

Section: Discussionmentioning

confidence: 99%

Insertion of a Fogarty catheter through a slip joint section for neonatal and infantile one-lung ventilation : a report of two cases

et al. 2021

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Here, we report two cases involving a neonate and child in which a slip joint section was used to thread a Fogarty catheter into the endotracheal tube for one-lung ventilation (OLV). Both the neonate and infant required OLV, and were placed under general anesthesia. A Fogarty catheter was used for OLV. The Fogarty catheter was passed into the intraluminal side of the endotracheal tube through a slip joint section. OLV was maintained successfully without severe air leakage or Fogarty catheter displacement. The neonate had been intubated pre-operatively with a 3.5-mm inner diameter endotracheal tube, and we used that tube. These cases indicate that the technique can be applied to pre-operatively intubated patients and does not require surgeons to exchange endotracheal tubes. Use of the slip joint section technique facilitates Fogarty catheter fixation without additional dead space.

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“…Both can be passed into the required bronchus using a guidewire and have the advantage of an end hole which allows suction and collapse of the lung. [ 20 21 ] Bronchial blockers are an effective strategy of lung isolation in small children; they can be introduced alongside a conventional ETT and positioned at a desirable level using a fiber optic bronchoscope (FOB). A 5F bronchial blocker is a better option compared to a Fogarty catheter which may cause mucosal damage because of the high-pressure balloon.…”

Section: Anesthesia For Cpam Surgerymentioning

confidence: 99%

“…The need for OLV has been questioned.Some surgeons may not request for collapsing the lung, as they retract the lung, providing adequate exposure at the operative site. [ 21 22 ] The decision of OLV should be discussed with the surgeon beforehand, as the provision of OLV requires an experienced anaesthesiologist. [ 23 ]…”

Section: Anesthesia For Cpam Surgerymentioning

confidence: 99%

“…They observed less pulmonary complications within 72 h when using lung-protective ventilation (tidal volume at 6 mL/kg during two lung ventilation and 4 mL/kg during OLV, with 6 cmH 2 0 PEEP) when compared with conventional mode of ventilation (tidal volume at 10 mL/kg and 8 mL/kg during two lung and OLV, respectively, without PEEP). [ 21 ]…”

Section: Anesthesia For Cpam Surgerymentioning

confidence: 99%

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Anesthetic considerations in patients with cystic pulmonary adenomatoid malformations

Gupta

Chaudhary

Hayaran

et al. 2021

Journal of Anaesthesiology Clinical Pharmacology

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Congenital pulmonary adenomatoid malformation (CPAM) is a rare entity. The authors searched the US National Library of Medicine Database, EMBASE, Google Scholar, PubMed Central for anesthetic management in CPAM. The search was performed using the terms: congenital cystic adenomatoid malformation, congenital pulmonary adenomatoid malformation, CCAM, CPAM, anesthetic management. The prognosis of CPAM depends on timely diagnosis, presence of hydrops, degree of hypoplasia of remaining lung, and the size of the lesion. Symptomatic patients must be treated surgically and lobectomy is considered the gold standard. Anesthetic management of such cases is challenging as it involves thoracotomy or thoracoscopic lobectomy or cystectomy and can lead to sudden hemodynamic Collapse. Early extubation should be considered to avoid iatrogenic ventilator-induced bronchial stump dehiscence resulting from positive pressure ventilation.

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Severe desaturation while attempting one-lung ventilation for congenital cystic adenomatoid malformation with respiratory distress syndrome in neonate -A case report-

Cited by 3 publications

References 13 publications

Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation

Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation

Insertion of a Fogarty catheter through a slip joint section for neonatal and infantile one-lung ventilation : a report of two cases

Anesthetic considerations in patients with cystic pulmonary adenomatoid malformations

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