One-Lung Ventilation: A Pediatric Simulation Case for Anesthesiology Residents

Area of Science:

• Medical Education
• Anesthesiology
• Pediatric Surgery

Background:

• Video-assisted thoracoscopic surgery (VATS) is increasingly used in pediatric procedures.
• One-lung ventilation (OLV) in pediatrics presents unique complexities for anesthesia trainees.
• A need exists for specialized educational tools to address these challenges.

Purpose of the Study:

• To develop and evaluate a high-fidelity simulation activity for pediatric OLV.
• To enhance midlevel and senior anesthesia trainees' skills in managing pediatric OLV.
• To provide a safe environment for practicing airway selection, lung isolation, and hypoxemia management.

Main Methods:

• A simulated 3-year-old patient undergoing VATS decortication for empyema.
• Focus on challenges: airway management, fiber optic-confirmed lung isolation, and hypoxemia during OLV.
• Utilized a pediatric medical simulator and a tracheobronchial tree model.

Main Results:

• Pilot trainees reported significant value, agreeing or strongly agreeing that the simulation improved their understanding.
• Specific gains noted in selecting lung isolation devices and managing hypoxia during pediatric OLV.
• Positive feedback indicated improved preparedness for managing pediatric OLV cases.

Conclusions:

• The simulation is integrated into the anesthesiology residency curriculum for education and evaluation.
• It serves as a tool for identifying knowledge gaps in perioperative pediatric OLV management.
• The activity reinforces didactic and clinical learning, with modifications based on user feedback.