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Pulmonary function after one-lung ventilation in newborns: the basis for neonatal thoracoscopy
M Tönz1, D Bachmann, D Mettler
1Department of Pediatric Surgery, University Children's Hospital, Bern, Switzerland.
The Annals of Thoracic Surgery
|September 2, 1998
Summary
One-lung ventilation (OLV) in newborn piglets had minimal impact on gas exchange and lung function. Prolonged lung collapse during OLV caused mild injury, evidenced by decreased compliance after reexpansion.
Area of Science:
- Neonatal Physiology
- Thoracic Surgery
- Pulmonary Medicine
Background:
- One-lung ventilation (OLV) is crucial for thoracic surgery but its effects on neonatal pulmonary function are not well understood.
- Maintaining lung exposure requires complete deflation, necessitating OLV in pediatric patients.
Purpose of the Study:
- To investigate the pulmonary and gas exchange effects of OLV in neonatal piglets.
- To assess the impact of prolonged lung collapse and reexpansion on respiratory mechanics.
Main Methods:
- Ten neonatal piglets underwent 120 minutes of OLV with 100% oxygen.
- Hemodynamics and gas exchange were serially monitored.
- Pulmonary function tests were conducted before and after OLV for each lung.
Main Results:
- Arterial oxygen saturation remained stable at 100% during OLV.
- Venous admixture and alveolar-arterial oxygen tension gradient showed slight, transient increases.
- Static compliance of the collapsed lung decreased significantly after reexpansion (p=0.008).
Conclusions:
- OLV in neonatal piglets results in minimal gas exchange alterations.
- Prolonged lung collapse followed by reexpansion led to mild lung injury, indicated by reduced compliance.
- The study suggests OLV is generally safe in neonates, with minor reversible pulmonary effects.