A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgery

Objectives: One-lung ventilation (OLV) for children under the age of two years is difficult. The authors hypothesize that a combination of a supraglottic airway (SGA) device and intraluminal placement of a bronchial blocker (BB) may provide an appropriate choice. Design: A prospective method-compari...

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Main Authors: Junlin Lv, Xiaoying Ding, Jing Zhao, Huijuan Zhang, Jiaojiao He, Lei Ma, Jianrui Lv
Format: Article
Language:English
Published: Elsevier 2023-02-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844023007831
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author Junlin Lv
Xiaoying Ding
Jing Zhao
Huijuan Zhang
Jiaojiao He
Lei Ma
Jianrui Lv
author_facet Junlin Lv
Xiaoying Ding
Jing Zhao
Huijuan Zhang
Jiaojiao He
Lei Ma
Jianrui Lv
author_sort Junlin Lv
collection DOAJ
description Objectives: One-lung ventilation (OLV) for children under the age of two years is difficult. The authors hypothesize that a combination of a supraglottic airway (SGA) device and intraluminal placement of a bronchial blocker (BB) may provide an appropriate choice. Design: A prospective method-comparison study. Setting: Second Affiliated Hospital of Xi'an Jiaotong University, China. Participants: 120 patients under the age of two years undergoing thoracoscopic surgery with OLV. Interventions: Participants were randomly assigned to receive intraluminal placement of BB with SGA (n = 60) or extraluminal placement of BB with endotracheal tube (ETT) (n = 60) for OLV. Measurements and main results: The primary outcome was the length of postoperative hospitalization stay. The secondary outcomes were the basic parameters of OLV and investigator-defined severe adverse events. The postoperative hospitalization stay was 6 days (interquartile range, IQR 4–9) in SGA plus BB group compared with 9 days (IQR 6–13) in ETT plus BB group (P = 0.034). The placement and positioning duration of SGA plus BB was 64 s (IQR 51–75) compared with 132 s (IQR 117–152) of ETT plus BB (P = 0.001). The values of leukocyte (WBC) and C-reactive protein (CRP) of SGA plus BB group on the first day of post-operation were 9.8 × 109/L (IQR 7.4–14.5) and 15.1 mg/L (IQR 12.5–17.3) compared with 13.6 × 109/L (IQR 10.8–17.1) and 19.6 mg/L (IQR 15.0–23.5) of ETT plus BB group (P = 0.022 and P = 0.014). Conclusion: There were few if any significant adverse events in the intervention group (SGA plus BB) for OLV in children under the age of two years, and this method seems worthy of clinical application. Meanwhile, the mechanism for this novel technique to shorten the length of postoperative hospitalization stay needs to be further explored.
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spelling doaj.art-17ff92d92caa4d10aed8ef5d40ed18652023-03-02T05:02:10ZengElsevierHeliyon2405-84402023-02-0192e13576A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgeryJunlin Lv0Xiaoying Ding1Jing Zhao2Huijuan Zhang3Jiaojiao He4Lei Ma5Jianrui Lv6Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, ChinaDepartment of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, ChinaDepartment of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, ChinaDepartment of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, ChinaDepartment of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, ChinaDepartment of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; Corresponding author. Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an, Shaanxi, China.Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; Corresponding author. Department of Anesthesiology, Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an, Shaanxi, China.Objectives: One-lung ventilation (OLV) for children under the age of two years is difficult. The authors hypothesize that a combination of a supraglottic airway (SGA) device and intraluminal placement of a bronchial blocker (BB) may provide an appropriate choice. Design: A prospective method-comparison study. Setting: Second Affiliated Hospital of Xi'an Jiaotong University, China. Participants: 120 patients under the age of two years undergoing thoracoscopic surgery with OLV. Interventions: Participants were randomly assigned to receive intraluminal placement of BB with SGA (n = 60) or extraluminal placement of BB with endotracheal tube (ETT) (n = 60) for OLV. Measurements and main results: The primary outcome was the length of postoperative hospitalization stay. The secondary outcomes were the basic parameters of OLV and investigator-defined severe adverse events. The postoperative hospitalization stay was 6 days (interquartile range, IQR 4–9) in SGA plus BB group compared with 9 days (IQR 6–13) in ETT plus BB group (P = 0.034). The placement and positioning duration of SGA plus BB was 64 s (IQR 51–75) compared with 132 s (IQR 117–152) of ETT plus BB (P = 0.001). The values of leukocyte (WBC) and C-reactive protein (CRP) of SGA plus BB group on the first day of post-operation were 9.8 × 109/L (IQR 7.4–14.5) and 15.1 mg/L (IQR 12.5–17.3) compared with 13.6 × 109/L (IQR 10.8–17.1) and 19.6 mg/L (IQR 15.0–23.5) of ETT plus BB group (P = 0.022 and P = 0.014). Conclusion: There were few if any significant adverse events in the intervention group (SGA plus BB) for OLV in children under the age of two years, and this method seems worthy of clinical application. Meanwhile, the mechanism for this novel technique to shorten the length of postoperative hospitalization stay needs to be further explored.http://www.sciencedirect.com/science/article/pii/S2405844023007831Supraglottic airwayBronchial blockerOne-lung ventilationAnesthesiaInfant
spellingShingle Junlin Lv
Xiaoying Ding
Jing Zhao
Huijuan Zhang
Jiaojiao He
Lei Ma
Jianrui Lv
A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgery
Heliyon
Supraglottic airway
Bronchial blocker
One-lung ventilation
Anesthesia
Infant
title A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgery
title_full A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgery
title_fullStr A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgery
title_full_unstemmed A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgery
title_short A combination of supraglottic airway and bronchial blocker for one-lung ventilation in infants undergoing thoracoscopic surgery
title_sort combination of supraglottic airway and bronchial blocker for one lung ventilation in infants undergoing thoracoscopic surgery
topic Supraglottic airway
Bronchial blocker
One-lung ventilation
Anesthesia
Infant
url http://www.sciencedirect.com/science/article/pii/S2405844023007831
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