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Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
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Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications

Published on: March 15, 2024

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External tracheal manipulation for bronchial blocker placement in children undergoing thoracic surgery requiring one

Ravish Kapoor1, Pascal Owusu-Agyemang1, Dilip R Thakar1

  • 1Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd. Unit #409, Houston, TX, USA.

Annals of Cardiac Anaesthesia
|May 3, 2021
PubMed

Insights

External tracheal manipulation (ETM) aids bronchial blocker (BB) placement during pediatric one lung ventilation (OLV). This technique offers a viable solution for challenging pediatric cases, improving oxygenation and ventilation.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Respiratory Medicine

Background:

  • Pediatric one lung ventilation (OLV) presents unique challenges compared to adults, stemming from anatomical and physiological differences.
  • Limited availability and size constraints of lung isolation devices complicate pediatric OLV.
  • Effective bronchial blocker (BB) placement is crucial for successful OLV but can be difficult in pediatric patients.

Observation:

  • A 2-, 8-, and 10-year-old patient undergoing thoracic surgery required OLV.
  • Fiberoptic bronchoscopy and BB insertion were challenging due to small airway sizes.
  • External tracheal manipulation (ETM) was employed to assist BB placement.

Findings:

  • ETM successfully facilitated the placement of BBs in all three pediatric patients.
  • The technique proved effective despite the anatomical limitations of pediatric airways.
  • Adequate oxygenation and ventilation were maintained throughout the procedures.

Implications:

  • ETM represents a potentially valuable adjunct for pediatric OLV, addressing limitations of current devices.
  • This method may improve the feasibility and safety of OLV in pediatric thoracic surgery.
  • Further research into ETM for pediatric airway management is warranted to explore its full potential.

Keywords:
Bronchial blockerpediatric one lung ventilationtracheal manipulation

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