Airway Management
Efficacy of bronchial blocker outside endotracheal tube for one-lung ventilation in pediatric patients
Xin Wenqi, Yan Zeng, Zhang Sen, Yang Qing, Li Aixiang, Zhang Yixuan
Published 2018-07-20
Cite as Chin J Anesthesiol, 2018,38(7): 863-865. DOI: 10.3760/cma.j.issn.0254-1416.2018.07.023
Abstract
ObjectiveTo evaluate the efficacy of bronchial blocker outside the endotracheal tube for one-lung ventilation (OLV) in pediatric patients.
MethodsThirty-eight American Society of Anesthesiologists physical status ⅠorⅡ patients of both sexes, aged 4-8 yr, weighing 14.0-28.6 kg, scheduled for elective thoracic surgery under general anesthesia, were enrolled in this study.The size of tracheal tube was selected according to the endotracheal diameter at the level of clavicle and sternum on chest X-ray.After anesthesia induction, the distal end of the bronchial blocker was bent toward the target bronchus with a videolaryngoscope and then inserted until resistance was felt, and the preselected tracheal tube was inserted with a videolaryngoscope at a depth of (age/2+ 12) cm.The position of the bronchial blocker was adjusted using a bronchofiberscope so that the upper edge of the blue cuff was 0.5-1.0 cm below the carina.The heart rate, mean arterial pressure, SpO2 and airway pressure were recorded, arterial blood gas analysis was performed, and PaCO2 and PaO2 were recorded immediately before OLV (T1), at 30 min after OLV (T2) and at the end of OLV (T3). The intubation time, success rate of intubation at first attempt, displacement of bronchial blocker and occurrence of postoperative laryngeal pain and hoarseness were recorded.The pulmonary collapse was evaluated according to the standard described by Campos.
ResultsCompared with the baseline at T1, PaO2 was significantly decreased and airway pressure was increased at T2, 3 (P<0.05), and no significant change was found in heart rate, mean arterial pressure, PaCO2 or SpO2 at T2, 3 (P>0.05). The average intubation time was(185±38)s.The success rate of intubation at first attempt, rate of bronchial blocker displacement, excellent and good rates of pulmonary collapse and incidence of laryngeal pain and hoarseness were 95%, 16%, 100% and 11%, respectively.
ConclusionBronchial blocker outside the endotracheal tube can be effectively used for OLV in pediatric patients.
Key words:
Intubation, intratracheal; Respiration, artificial; Child
Contributor Information
Xin Wenqi
Department of Anesthesiology, Huaihe Hospital Affiliated to Henan University, Kaifeng 475000, He′nan, China
Yan Zeng
Department of Anesthesiology, Huaihe Hospital Affiliated to Henan University, Kaifeng 475000, He′nan, China
Zhang Sen
Department of Anesthesiology, Children′s Hospital of Kaifeng City, Kaifeng 475000, Henan, China
Yang Qing
Department of Anesthesiology, Huaihe Hospital Affiliated to Henan University, Kaifeng 475000, He′nan, China
Li Aixiang
Department of Anesthesiology, Huaihe Hospital Affiliated to Henan University, Kaifeng 475000, He′nan, China
Zhang Yixuan
Department of Anesthesiology, Huaihe Hospital Affiliated to Henan University, Kaifeng 475000, He′nan, China
