Intracuff pressure during one-lung ventilation in infants and children.

OBJECTIVE

We prospectively evaluated intracuff pressure (IP) during one-lung ventilation (OLV) to characterize potential risk associated with overinflation of the cuff used for OLV.

DESIGN

Prospective observational study over a 2-year period, in infants and children undergoing thoracic surgery. The IPs of the tracheal and bronchial balloon were measured using a manometer and compared to a previously recommended threshold of 30 cmH2O. Data were compared by the device type used to achieve OLV.

SETTING

Freestanding tertiary-care pediatric hospital.

PARTICIPANTS

Patients ≤18 years of age undergoing thoracic procedures requiring OLV.

INTERVENTIONS

Measurement of IP.

MEASUREMENTS AND MAIN RESULTS

Thirty patients were enrolled (age 5 months-18 years) with a median weight of 28 kg. Median tracheal and bronchial IPs were 32 cmH2O (range: 11, 90) and 44 cmH2O (range: 10, 100), respectively. The tracheal and bronchial IPs exceeded 30 cmH2O in 13 of 20 patients (65%) and 21 of 30 patients (70%), respectively.

CONCLUSIONS

IP was high and in excess of recommended levels in most children undergoing OLV. Continuous monitoring of IP may be indicated during OLV to address the risks involved and ensure the prevention of complications related to high IP.

TYPE OF STUDY

Prospective comparative study.

LEVEL OF EVIDENCE

Level II.