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Anesthetic Management in Children with Congenital Lobar Emphysema
1Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Palandoken, Erzurum, Turkey.
Insights
Anesthetic management for congenital lobar emphysema (CLE) in children is complex. Close collaboration between surgical and anesthesia teams is crucial for successful outcomes in these challenging cases.
Area of Science:
- Pediatric Anesthesiology
- Thoracic Surgery
- Respiratory Medicine
Background:
- Congenital lobar emphysema (CLE) is a rare condition of unknown etiology.
- It is characterized by lung lobe hyperinflation, posing significant respiratory challenges.
Purpose of the Study:
- To describe the anesthetic management strategies for pediatric patients with CLE.
- To evaluate the outcomes of surgical treatment for CLE in a single center.
Main Methods:
- Retrospective review of 10 children treated for CLE between 1995 and 2014.
- Analysis of diagnostic imaging, clinical presentation, surgical procedures, anesthetic techniques, and patient outcomes.
Main Results:
- All 10 patients (6 males, 4 females) aged 40 days to 6 years presented with dyspnea.
- Patients were successfully extubated in the operating room with no post-operative respiratory distress, mortality, or morbidity.
- Post-operative pain was managed effectively with intrapleural catheters.
Conclusions:
- Anesthetic management for CLE patients requires careful planning and execution.
- Close collaboration between surgical and anesthesia teams is essential.
- Minimizing the time from anesthesia induction to thoracotomy is recommended.
Background:
The cause of congenital lobar emphysema (CLE) is unknown and characterized by hyperinflation of one or more lobes of the lung. The purpose of this retrospective study was to present the anesthetic management of children with congenital lobar emphysema (CLE) receiving treatment in our center.
Methods:
Ten children underwent CLE-related surgical treatment in our center between March 1995 and August 2014. All cases were diagnosed on the basis of postero-anterior chest radiography and computerized tomography. Age, sex, preoperative clinical findings, location of lesions, surgical and anesthetic procedures, results of anesthesia and duration of hospitalization were evaluated.
Results:
Six patients were male (60%) and four female (40%). Their ages ranged from 40 days to 6 years. Dyspnea was present in all cases and severe in four of them. Four patients had emphysema in the left upper lobe, three in the right middle lobe, one in the right upper lobe and one in the left lower lobe. All patients were extubated in the operating room and none experienced post-operative respiratory distress. Post-operative analgesia was provided via the previously placed intrapleural catheter. All the patients were extubated in the operation room. There was no post-operative mortality or morbidity.
Conclusions:
Anesthetic management of patients with CLE is challenging. In these patients the surgical team and -anesthetists should collaborate closely and the time between anesthesia induction and thoracotomy should be as short as possible.
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