Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd. Unit #409, Houston, TX, USA.
Ann Card Anaesth. 2021 Jan-Mar;24(1):105-107. doi: 10.4103/aca.ACA_56_19.
Limited options exist for pediatric one lung ventilation (OLV). Compared to adults, pediatric OLV can be more challenging due to physiological/anatomical differences, various pathologies, and size limitations of lung isolation devices. Fiberoptic bronchoscopy can be harder due to the restricted tube sizes through which bronchial blockers (BB) and scopes can appropriately fit, while providing adequate oxygenation and ventilation. Recent literature is sparse concerning facilitation of BB placement in children. A 2-, 8-, and 10-year-old presented for thoracic surgeries requiring OLV. External tracheal manipulation (ETM) facilitated BB placement in each case and can potentially offer unique advantages in pediatric OLV.
小儿单肺通气(OLV)的选择有限。与成人相比,由于生理/解剖差异、各种病理和肺隔离装置的尺寸限制,小儿 OLV 可能更具挑战性。纤维支气管镜检查可能更具挑战性,因为支气管阻塞器(BB)和内镜通过的管腔尺寸受限,而 BB 和内镜需要适当的适配才能提供足够的氧合和通气。关于 BB 在儿童中的放置便利性的相关文献很少。本研究报道了 3 例分别为 2、8 和 10 岁的患儿,他们因需要 OLV 的胸部手术而就诊。在每种情况下,均采用外部气管操作(ETM)来辅助 BB 的放置,并且 ETM 可能在小儿 OLV 中具有独特的优势。