Abstract
Anesthesiologists caring for infants and children who require a thoracic surgical procedure face many challenges. In particular, the airway equipment needed requires special skills and understanding of the limited space available in the airway for proper placement of special tracheal tubes. A working knowledge of respiratory physiology and anatomy in infants and children is also required for the planning and execution of appropriate intraoperative care. The appropriate airway device and its size in a particular child depend on the pathology being managed, physiological changes, the child's age and size and the surgical technique used. Specialized techniques such as anesthesia for thoracoscopy or video assisted thoracic surgery (VATS), one lung ventilation and anesthesia related issues, the use of bronchial blockers, Univent tubes, double lumen tubes, and consideration of specific lesions such as subglottic stenosis, pulmonary sequestration lesions, bronchogenic cysts, cystic adenomatoid malformation, congenital lobar emphysema, congenital diaphragmatic hernia, tracheoesophageal fistula and esophageal atresia are discussed. The pathophysiology and management strategies for anterior mediastinal masses, including an algorithm for evaluation of these masses, are also presented.
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