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Gomes SH, Miranda A, Pêgo JM, Costa PS, Correia-Pinto J. Ultrasound-Guided Selective Bronchial Intubation: A Feasibility Study in Pediatric Animal Model. Front Med (Lausanne) 2022; 9:869771. [PMID: 35783614 PMCID: PMC9240755 DOI: 10.3389/fmed.2022.869771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Selective one-lung ventilation used to optimize neonatal and pediatric surgical conditions is always a demanding task for anesthesiologists, especially during minimally invasive thoracoscopic surgery. This study aims to introduce an ultrasound-guided bronchial intubation and exclusion technique in a pediatric animal model. Methods Seven rabbits were anesthetized and airway ultrasound acquisitions were done. Results Tracheal tube progression along the trachea to the right bronchus and positioning of the bronchial blocker in the left bronchus were successfully done with consistent ultrasound identification of relevant anatomical structures. Conclusion The study provided a new application of ultrasound in airway management. More advanced experimental studies are needed since this technique has the potential for translation to pediatric anesthesia.
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Affiliation(s)
- Sara Hora Gomes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Portugal
- *Correspondence: Sara Hora Gomes,
| | - Alice Miranda
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Portugal
| | - José Miguel Pêgo
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Portugal
| | - Patrício S. Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Portugal
| | - Jorge Correia-Pinto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Portugal
- Department of Pediatric Surgery, Hospital de Braga, Braga, Portugal
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Honikman R, Rodriguez-Diaz CA, Cohen E. A Ballooning Crisis: Three Cases of Bronchial Blocker Malfunction and A Review. J Cardiothorac Vasc Anesth 2017; 31:1799-1804. [PMID: 28476448 DOI: 10.1053/j.jvca.2017.02.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Rafael Honikman
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
| | | | - Edmond Cohen
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY
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Kamra SK, Jaiswal AA, Garg AK, Mohanty MK. Rigid Bronchoscopic Placement of Fogarty Catheter as a Bronchial Blocker for One Lung Isolation and Ventilation in Infants and Children Undergoing Thoracic Surgery: A Single Institution Experience of 27 Cases. Indian J Otolaryngol Head Neck Surg 2016; 69:159-171. [PMID: 28607884 DOI: 10.1007/s12070-016-1026-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 10/05/2016] [Indexed: 11/30/2022] Open
Abstract
One-lung ventilation (OLV) is a challenging task in infants and children as few techniques are possible because of narrow anatomy. The aim of this study is to evaluate and experience lung isolation with Fogarty catheters as a bronchial blocker placed by rigid bronchoscope for OLV in infants and children with lung pathologies requiring surgical management in an industrial hospital. This study is a prospective study carried out in J.L.N. Hospital and Research Centre, Bhilai (CG), from January 2011 to December 2014. The study was designed to place Fogarty catheter for achieving OLV using rigid bronchoscope in children. The patient and anaesthesia characteristics, placement and positioning of Fogarty catheters, intraoperative course, complications and recovery of the patient were studied. The data were then compared with the relevant and available literature. Over the study period of 4 years, 27 cases were included, out of which 22 (81.48 %) cases had suppurative lung disease, three cases (11.11 %) had hydatid cyst of the lung, whereas one case (3.7 %) each of congenital lobar emphysema and congenital cystic adenomatoid malformation of the lung, respectively. In all cases general anaesthesia was provided using single lumen endotracheal tube and one lung ventilation achieved by parallel placement of Fogarty catheter as a bronchial blocker with rigid bronchoscope. The surgical management included thoracotomy with decortication in 21 cases, thoracotomy with excision of hydatid cyst in 3 cases, video-assisted thoracoscopic surgery, thoracotomy with left upper lobectomy and thoracotomy with left lower lobectomy in one case each, respectively. There were no major intraoperative and postoperative complications. There was no mortality in our study. We conclude that rigid bronchoscope can be safely and effectively used to place Fogarty catheter in main bronchus in infants and children for achieving OLV.
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Affiliation(s)
- Sunil Kant Kamra
- Department of Anaesthesia, J.L.N. Hospital and Research Centre, Bhilai, CG India
| | - Ashwin Ashok Jaiswal
- Department of ENT and Head Neck Surgery, J.L.N. Hospital and Research Centre, Sector 9, Bhilai, Dist. Durg, CG 490009 India
| | - Amrish Kumar Garg
- Department of ENT and Head Neck Surgery, J.L.N. Hospital and Research Centre, Sector 9, Bhilai, Dist. Durg, CG 490009 India
| | - Manoj Kumar Mohanty
- Department of Paediatric Surgery, J.L.N. Hospital and Research Centre, Bhilai, CG India
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Cerchia E, Ferrero L, Molinaro F, Donato L, Messina M, Becmeur F. Pediatric Thoracoscopy and Bronchial Blockers: The Continued Search for the Ideal One-Lung Ventilation. J Laparoendosc Adv Surg Tech A 2016; 26:153-6. [DOI: 10.1089/lap.2015.0235] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Elisa Cerchia
- Pediatric Surgery Unit, Department of Medical Sciences, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Luisa Ferrero
- Department of Pediatric Surgery, University Hospital of Strasbourg, Hautepierre Hospital, Strasbourg, France
| | - Francesco Molinaro
- Pediatric Surgery Unit, Department of Medical Sciences, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Lionel Donato
- Department of Pediatric Surgery, University Hospital of Strasbourg, Hautepierre Hospital, Strasbourg, France
| | - Mario Messina
- Pediatric Surgery Unit, Department of Medical Sciences, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - François Becmeur
- Department of Pediatric Surgery, University Hospital of Strasbourg, Hautepierre Hospital, Strasbourg, France
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Kim D, Son JS, Lim H, Lee JH, Jang EJ. The tip fracture of the Coopdech bronchial blocker during insertion in the patient with lung surgery. Korean J Anesthesiol 2015; 67:S7-8. [PMID: 25598915 PMCID: PMC4295989 DOI: 10.4097/kjae.2014.67.s.s7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Deokkyu Kim
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Ji-Seon Son
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Hyungsun Lim
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Jun Ho Lee
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Eun Joo Jang
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
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Suzuki T, Ikeda H, Iwamoto T, Sano H, Hashimoto M, Oe K, Inoue H, Serada K. Elective use of an uncuffed small-bore cricothyrotomy tube with balloon occlusion of the subglottic airway. Can J Anaesth 2013; 61:39-45. [PMID: 24158854 DOI: 10.1007/s12630-013-0057-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 10/10/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To conduct a qualitative observational study on positive pressure ventilation through a percutaneous uncuffed small-bore cricothyrotomy tube with balloon occlusion of the subglottic airway to minimize supraglottic leak. CLINICAL FEATURES Ten consecutive procedures were performed in the nine men enrolled in this study. The demographics of the participants were: aged 50-73 yr, weight 48-87 kg, American Society of Anesthesiologists class I-II, and scheduled for endoscopic submucosal dissection via flexible endoscopy for en bloc resection of superficial meso- and hypopharyngeal cancer. The airway was initially secured with a supraglottic airway (SGA) under sevoflurane-based anesthesia, and a cricothyrotomy was then performed using a Portex(®) Minitrach II uncuffed cricothyrotomy tube (4-mm internal diameter). Following SGA removal, a Coopdech(®) bronchial blocker was orally or nasally inserted, and the balloon was inflated to occlude the trachea immediately beneath the glottis. The ventilator setting was initially based on observation of chest motion and end-tidal carbon dioxide tension and then readjusted according to arterial blood gas levels. All procedures were completed within a median time of 149 min. Effective ventilation was achieved in all patients despite mild hypercapnia (PaCO2 of 58 mmHg at maximum) in some patients. SpO2 levels were maintained at ≥ 98%. CONCLUSION This technique provides effective intraoperative ventilation and easy endoscopic access, and it countermeasures against the likely complication of postoperative laryngeal edema. Moreover, there is no need for conventional tracheostomy or prolonged intubation. This approach establishes a curative and less invasive pharyngeal cancer therapy. Certain adverse outcomes can be avoided, including impaired speech and swallowing, possible delayed closure of the stoma, or a compromised cosmetic outcome.
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Affiliation(s)
- Takashi Suzuki
- Department of Anesthesia, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-Chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan,
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Niwal N, Ranganathan P, Divatia J. Bronchial blocker for one-lung ventilation: An unanticipated complication. Indian J Anaesth 2013; 55:636-7. [PMID: 22223921 PMCID: PMC3249884 DOI: 10.4103/0019-5049.90638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Namrata Niwal
- Departments of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Parel, Mumbai, India
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The bronchial blocker: why will it not come out? J Pediatr Surg 2011; 46:2426-8. [PMID: 22152897 DOI: 10.1016/j.jpedsurg.2011.05.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 04/29/2011] [Accepted: 05/30/2011] [Indexed: 11/22/2022]
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