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Anesthetic management of pulmonary surgery in newborns and infants

Marco Caruselli1, Daniele Galvagni1, Julia Boubnova2

  • 1Anesthesia and Intensive Care Unit, La Timone Children's Hospital, AP-HM, Marseille.

Pediatric Reports
|September 14, 2020
PubMed

Insights

Anesthetic protocols for infant thoracoscopic surgery involving single-lung ventilation are detailed. This study highlights key monitored parameter variations during this challenging procedure for congenital pulmonary airway malformations.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Thoracic Surgery

Background:

  • Congenital pulmonary airway malformations (CPAMs) like cystic adenoid malformation, congenital lobar emphysema, and bronchogenic cysts are common in infants.
  • Surgical intervention, preferably via thoracoscopy within the first year of life, is crucial to prevent pneumopathy.
  • Intraoperative monopulmonary ventilation is essential for surgical access but presents anesthetic challenges in neonates and infants.

Purpose of the Study:

  • To describe the anesthetic protocol used for thoracoscopic surgery in infants.
  • To document variations in monitored physiological parameters during intraoperative monopulmonary ventilation.
  • To provide insights into managing anesthesia for complex pediatric thoracic procedures.

Main Methods:

  • Retrospective analysis of anesthetic records for infants undergoing thoracoscopic surgery.
  • Detailed description of the anesthetic protocol, including induction, maintenance, and emergence.
  • Monitoring and analysis of hemodynamic and respiratory parameters during monopulmonary ventilation.

Main Results:

  • Specific anesthetic agents and techniques employed were identified.
  • Significant variations in heart rate, blood pressure, and oxygen saturation were observed during monopulmonary ventilation.
  • The study outlines the successful management of these anesthetic challenges.

Conclusions:

  • Establishing a standardized anesthetic protocol is vital for safe thoracoscopic surgery in infants.
  • Close monitoring of physiological parameters is critical to manage intraoperative challenges during monopulmonary ventilation.
  • This approach facilitates effective surgical treatment of congenital pulmonary airway malformations in neonates and infants.

Keywords:
anesthesiacongenital pulmonary airways malformationsinfantsnewbornthoracic surgery

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