Templeton Thomas Wesley, Templeton Leah B, Lawrence Ann E, Sieren Leah M, Downard Martina G, Ririe Douglas G
Department of Anesthesiology (Pediatric Anesthesia), Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Surgery (Pediatric Surgery), Wake Forest School of Medicine, Winston-Salem, NC, USA.
Paediatr Anaesth. 2018 Apr;28(4):347-351. doi: 10.1111/pan.13342. Epub 2018 Feb 11.
The need for 1-lung ventilation in school age, pediatric patients is uncommon and as a result there are relatively few devices available to facilitate lung isolation in this population. Furthermore, little is known about the efficacy and techniques of placement of the currently available devices. One of the newest devices available that may be appropriate in this age group is the EZ-Blocker.
We aimed to examine our initial experience with the EZ-Blocker to evaluate the performance of this device with respect to potential improvements in technique and patient selection going forward.
We performed a retrospective chart review of all pediatric patients who underwent 1-lung ventilation with an EZ-Blocker since the blocker became available at our institution. We recorded demographics, details of placement, intraoperative course, number of repositions, and any postoperative morbidity related to blocker placement or 1-lung ventilation.
We were able to correctly place the EZ-Blocker and achieve lung isolation in 8 of 11 patients. There was a single episode of repositioning required during 1-lung ventilation with an EZ-Blocker.
The EZ-Blocker was successful in providing lung isolation for a majority of our school age patients. Size constraints in children <6 years of age, excessive secretions, and distortions of tracheal anatomy seemed to be the greatest hindrances to successful placement and positioning of the device. Once correctly positioned, however, the EZ-Blocker may be more stable than the Arndt endobronchial blocker.
学龄期儿科患者需要进行单肺通气的情况并不常见，因此适用于该人群进行肺隔离的设备相对较少。此外，对于现有设备的有效性和放置技术了解甚少。EZ-Blocker是目前可用于该年龄组的最新设备之一。
我们旨在研究使用EZ-Blocker的初步经验，以评估该设备在技术和患者选择方面的潜在改进情况。
我们对自EZ-Blocker在我们机构可用以来所有接受单肺通气的儿科患者进行了回顾性病历审查。我们记录了人口统计学资料、放置细节、术中过程、重新定位次数以及与封堵器放置或单肺通气相关的任何术后并发症。
我们能够在11例患者中的8例中正确放置EZ-Blocker并实现肺隔离。在使用EZ-Blocker进行单肺通气期间需要进行一次重新定位。
EZ-Blocker成功地为大多数学龄期患者提供了肺隔离。6岁以下儿童的尺寸限制、过多分泌物以及气管解剖结构的变形似乎是该设备成功放置和定位的最大障碍。然而，一旦正确定位，EZ-Blocker可能比Arndt支气管内封堵器更稳定。
