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A novel lung recruitment technique in pediatric patients with congenital heart diseases: A case series
Jigisha Chandrakant Pujara1, Guriqbal Singh1, Sunil Ninama1
1Department of Cardiac Anesthesia, U. N. Mehta Institute of Cardiology and Research Centre, Affiliated to B. J. Medical College, Ahmedabad, Gujarat, India.
Insights
A novel lung recruitment technique successfully treated left lung atelectasis in pediatric cardiac surgery patients. This method aided in early ventilator weaning and shortened mechanical ventilation duration.
Area of Science:
- Pediatric Critical Care Medicine
- Cardiothoracic Surgery
- Respiratory Physiology
Background:
- Lung recruitment maneuvers are crucial for improving pulmonary mechanics and facilitating early ventilator weaning.
- Left lung atelectasis is a significant complication in pediatric patients undergoing corrective surgery for congenital heart disease.
- Current recruitment techniques may have limitations in specific pediatric cardiac surgical populations.
Purpose of the Study:
- To describe a novel lung recruitment technique for pediatric patients with left lung atelectasis post-congenital heart surgery.
- To evaluate the efficacy of this technique in achieving lung segment recruitment and facilitating early extubation.
- To assess the safety and outcomes associated with the novel recruitment strategy.
Main Methods:
- A cohort of four pediatric patients with left lung atelectasis post-congenital heart surgery were treated with a novel lung recruitment technique.
- The technique involved elective endobronchial intubation, suctioning, chest physiotherapy (vibration and percussion), and intermittent ventilation with 100% oxygen.
- Procedure success was monitored via auscultation and chest X-ray.
Main Results:
- Successful recruitment of collapsed lung segments and resolution of atelectasis were confirmed in all four patients.
- All patients were successfully weaned from mechanical ventilation within 24-48 hours post-procedure.
- One patient experienced contralateral lung collapse post-extubation, managed conservatively; another had transient bradycardia and desaturation during the procedure.
Conclusions:
- This novel lung recruitment technique is effective in recruiting collapsed lung segments in pediatric cardiac surgery patients.
- The technique facilitates early ventilator weaning and reduces the overall duration of mechanical ventilation.
- The described method offers a potentially valuable approach for managing left lung atelectasis in this specific patient population.
Background:
Lung recruitment techniques are employed to help in improvement of pulmonary mechanics, facilitate early weaning, and shorten the duration of mechanical ventilation. We are reporting a novel lung recruitment technique employed in four children with left lung atelectasis, who underwent corrective surgery for congenital heart disease.
Materials And Methods:
From January 2020 to March 2021, four pediatric cardiac patients having left lung atelectasis, undergoing corrective surgery were subjected to lung recruitment technique and had elective endobronchial intubation and suctioning with chest physiotherapy in the form of vibration and percussion. This was done along with intermittent ventilation with 100% oxygen.
Results:
Successful recruitment of lung segments and clearance of atelectasis were confirmed by auscultation and chest X-ray in all four patients. All the cases were successfully weaned off the ventilator within 24-48 h. One patient had an opposite lung collapse after extubation, which was managed conservatively with chest physiotherapy. Another patient had bradycardia and desaturation during the procedure, which was improved after withdrawing the tube and instituting two lung ventilation with 100% oxygen.
Conclusions:
This novel lung recruitment technique helps in recruitment of collapsed lung segments and thus helps in early weaning and shortens the duration of mechanical ventilation.
