Pawar Dilip K, Marraro Giuseppe A
All India Institute of Medical Sciences, New Delhi, India.
Paediatr Anaesth. 2005 Mar;15(3):204-8. doi: 10.1111/j.1460-9592.2005.01421.x.
Our objective was to evaluate the efficacy of selective bronchial intubation and independent lung ventilation during thoracic surgery in children up to 3 years, using a double lumen tube.
We studied retrospective (cases 1-6) and prospective cases (7-17) between January 1996 and December 2000 at the All India Institute of Medical Sciences, New Delhi, India and at Fatebenefratelli and Ophthalmiatric Hospital, Milan, Italy. Seventeen children, 1 day to 3 years of age and weighing 2.7-12 kg, were submitted to thoracic surgery for a variety of surgical conditions. Anesthesia was conducted as usual in this type of patient and selective intubation was performed using a double lumen tube (Marraro Pediatric double lumen tube). During the operation one lung ventilation was applied and at the end of surgery the collapsed lung was reexpanded independently from the contralateral lung.
Six children remained intubated with a double lumen tube for between 8 and 48 h and one (case no. 11) with a single lumen tube for 24 h, while 10 of the older children were extubated on the table. No serious complications during or after surgery were noted and after extubation all the children recovered completely without sequelae.
The double lumen tube appears to be very effective in allowing one lung ventilation in this age group during thoracic surgery.
我们的目的是评估在3岁及以下儿童的胸外科手术中，使用双腔管进行选择性支气管插管和独立肺通气的疗效。
我们对1996年1月至2000年12月期间在印度新德里全印度医学科学研究所以及意大利米兰法塔贝纳费拉特利眼科医院进行的回顾性病例（病例1 - 6）和前瞻性病例（病例7 - 17）进行了研究。17名年龄在1天至3岁、体重2.7 - 12千克的儿童因各种外科病症接受胸外科手术。对这类患者按常规进行麻醉，并使用双腔管（马罗罗小儿双腔管）进行选择性插管。手术期间进行单肺通气，手术结束时塌陷的肺独立于对侧肺重新扩张。
6名儿童使用双腔管插管8至48小时，1名儿童（病例11）使用单腔管插管24小时，而10名年龄较大的儿童在手术台上拔管。手术期间及术后未发现严重并发症，拔管后所有儿童均完全康复，无后遗症。
双腔管在该年龄组的胸外科手术中进行单肺通气时似乎非常有效。
