Huang J, Cao H, Chen Q, Zhou C, Wang Z, Wu D, Hong J, Hong S. The Comparison Between Bronchial Occlusion and Artificial Pneumothorax for Thoracoscopic Lobectomy in Infants.
J Cardiothorac Vasc Anesth 2020;
35:2326-2329. [PMID:
33262037 DOI:
10.1053/j.jvca.2020.11.014]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE
To compare the difference between single-lung ventilation with bronchial occlusion and double-lung ventilation with carbon dioxide artificial pneumothorax for thoracoscopic lobectomy in infants.
DESIGN
This was a retrospective study.
SETTING
It was done in a teaching hospital.
PARTICIPANTS
Between March 2017 and April 2020, a total of 72 infants underwent thoracoscopic lobectomy in the authors' hospital.
INTERVENTIONS
Twenty-one patients received single-lung ventilation with bronchial occlusion, and 51 patients received carbon dioxide (CO2) artificial pneumothorax.
MEASUREMENTS
The patient data included the endotracheal tube length, surgical exposure, intraoperative blood loss, and surgery duration. The mean arterial pressure (MAP), central venous pressure (CVP) and peak inspiratory pressure (Ppeak), partial pressure of oxygen in arterial blood (PaO2), and partial pressure of carbon dioxide in arterial blood (PaCO2) were measured at four points: time of bilateral lung ventilation before the thoracic surgery (T0), 10 minutes after the surgery started (T1), 30 minutes after the surgery started (T2), 60 minutes after the surgery started (T3), and 10 minutes after the surgery was over (T4).
MAIN RESULTS
Compared to artificial pneumothorax, the bronchial occlusion group has the following advantages: the surgical exposure was better, the surgery duration was shorter, there was less intraoperative bleeding, and the duration of tracheal intubation was shorter (p < 0.05); bronchial occlusion resulted in a lower MAP but a higher CVP in infants at T1, T2, and T3 (p < 0.05) than the artificial pneumothorax group and resulted in a lower PaCO2 and higher PaO2 at T2, T3, and T4 (p < 0.05). There was no significant difference in Ppeak between the two groups (p > 0.05).
CONCLUSION
Compared with CO2 artificial pneumothorax, bronchial occlusion is more favorable for thoracoscopic lobectomy in infants.
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