[Lung separation in childhood : Anaesthesia management with physiological and technical challenges]

Lung separation for thoracic surgery is associated with varying degrees of difficulty depending on the age group. While the anatomical, physiological and technical requirements for the appropriate selection of bronchial blockers and double-lumen tubes in children > 12 years of age are comparable to those for adults, this is not the case for newborns and infants; however, at 13% they constitute the second largest group of children requiring lung surgery. Lung separation in this age group is technically demanding. The rate of cardiopulmonary complications is many times higher than in older children and adults. These procedures are therefore an anesthesiological challenge that should only be performed in specialized pediatric anesthesiology centers with appropriate personnel and structural facilities. In infants extubation should also be attempted on table to shorten the recovery time. This requires sufficient and multimodal pain therapy. The development of an internal enhanced recovery after surgery (ERAS) protocol can be helpful for high-quality perioperative treatment.