An Update on One-Lung Ventilation in Children

医学 插管 通风(建筑) 分离(微生物学) 重症监护医学 外科 机械工程 生物 微生物学 工程类
作者
T. Wesley Templeton,Federico Piccioni,Debnath Chatterjee
出处
期刊:Anesthesia & Analgesia [Lippincott Williams & Wilkins]
卷期号:132 (5): 1389-1399 被引量:41
标识
DOI:10.1213/ane.0000000000005077
摘要

One-lung ventilation in children continues to present technical and sometimes physiologic challenges to the clinician. The rarity of these cases at any single institution, however, has led to very few prospective trials to guide best practices. As a result, most clinicians continue to be guided by local tradition and preference. That said, the development of new bronchial blockers such as the EZ-Blocker or blocking devices such as the Univent tube have continued to evolve the practice of lung isolation in children. Further, the development of a variety of extraluminal blocker techniques has led to innovations in practice through a relatively diverse landscape of published case series offering different approaches to one-lung ventilation during the past 15 years. The Arndt bronchial blocker continues to represent the most well documented of these devices. Additionally, recent advances have occurred in our understanding of the relevant anatomic constraints of the lower pediatric airway. This review is intended to provide a comprehensive and practical update to practicing pediatric anesthesiologists to further their understanding of the modern practice of one-lung ventilation for thoracic surgery in children.
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