Thoracoscopy in the pediatric patient.

The pediatric applications of minimally invasive surgical procedures such as thoracoscopy continue to increase. Specific alterations in anesthetic management may be required during the perioperative care of these patients. This article reviews the anesthetic care of infants and children during thoracoscopy with emphasis on cardiopulmonary disturbances of the patient, techniques to isolate the operative and nonoperative lungs and provide one-lung ventilation to improve surgical visualization, cardiopulmonary alterations induced by the creation of the artificial pneumothorax or the absorption of CO2 by the plural surface, intraoperative management of one-lung ventilation, and the potential for and treatment of inadvertent CO2 embolism.