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Abstract
The main congenital pulmonary airways malformations in newborns and infants requiring surgery are cystic adenoid malformation, congenital lobar emphysema and bronchogenic cyst. The surgical treatment preferably via thoracoscopy is recommended within the first year of life to avoid the risk of pneumopathy. A monopulmonary ventilation is then required by the surgeon to operate the diseased lung. The anesthetic management of intraoperative mono-pulmonary ventilation in newborns and infants is always challenging for the anesthesiologist. The main objective of this study was to describe anesthetic protocol for thoracoscopy and variations of monitored parameters during a mono-pulmonary ventilation procedure in newborns and infants.
Highlights
We retrospectively analyzed charts of newborns and infants who underwent lung surgery for congenital malformation pulmonary diseases between January 1st 2013 and December 31th 2019 in our problems compared to thoracic surgery techniques; FM participated in the drafting of the article and in the analysis of anesthesiological problem
The bronchial blocker (BB) technique maximal SpO2 and ETCO2, respectively; sufentanil 0,2 mcg/kg) and muscle relaxant was performed on 7 patients in the right side
Ventilatory parameters (RR, respiratory rate and tidal volume) and duration of surgery lung and mono-pulmonary ventilation were obtained before placing the patient in lateral decubitus position
Summary
We retrospectively analyzed charts of newborns and infants who underwent lung surgery for congenital malformation pulmonary diseases between January 1st 2013 and December 31th 2019 in our problems compared to thoracic surgery techniques; FM participated in the drafting of the article and in the analysis of anesthesiological problems. The bronchial blocker (BB) technique maximal SpO2 and ETCO2, respectively; sufentanil 0,2 mcg/kg) and muscle relaxant was performed on 7 patients in the right side. The patients in the two groups (bronchial blocker vs selective intubation) were by 5 points in the BB group and by [3,5] in the SI group. Ventilatory parameters (RR, respiratory rate and tidal volume) and duration of surgery lung and mono-pulmonary ventilation were obtained before placing the patient in lateral decubitus position. In the second case before proceeding to selective e intubation the measurement of the s endotracheal tube at the level of the dental arch was noted and used for the postoperative u placement of the tube All these maneuvers l were carried out under fibroscopic control and ia thoracic auscultation confirmed the c pulmonary unilateral ventilation.
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