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An Update on One-Lung Ventilation in Children

T Wesley Templeton1, Federico Piccioni2, Debnath Chatterjee3

  • 1From the Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Anesthesia and Analgesia
|November 20, 2020
PubMed

Insights

Pediatric one-lung ventilation presents challenges due to limited trials. This review updates anesthesiologists on modern lung isolation techniques and devices for pediatric thoracic surgery.

Area of Science:

  • Pediatric Anesthesiology
  • Thoracic Surgery
  • Respiratory Physiology

Background:

  • One-lung ventilation (OLV) in children poses significant technical and physiological challenges.
  • Limited prospective trials necessitate reliance on traditional practices for pediatric OLV.
  • Advancements in devices and understanding of pediatric airway anatomy are evolving OLV practices.

Purpose of the Study:

  • To provide a comprehensive and practical update on modern one-lung ventilation for pediatric thoracic surgery.
  • To review current best practices and emerging techniques in pediatric lung isolation.
  • To address the challenges and innovations in pediatric OLV.

Main Methods:

  • Review of recent literature and case series on pediatric one-lung ventilation.
  • Discussion of evolving bronchial blockers and extraluminal devices.
  • Analysis of advancements in understanding pediatric airway anatomy.

Main Results:

  • Newer devices like EZ-Blocker and Univent tubes have improved lung isolation in children.
  • The Arndt bronchial blocker is well-documented among available extraluminal techniques.
  • Improved understanding of pediatric airway anatomy informs safer OLV practices.

Conclusions:

  • Modern pediatric one-lung ventilation relies on evolving devices and a better grasp of airway anatomy.
  • Continued education and adoption of innovative techniques are crucial for optimizing pediatric OLV.
  • This review offers practical insights for anesthesiologists managing pediatric thoracic cases requiring OLV.

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