| Anesthetic management of video-assisted thoracoscopic surgery (VATS) in pediatric patients: the issue of safety in infant and younger children. | |
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MedLine Citation:
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PMID: 20740214 Owner: NLM Status: PubMed-not-MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to assess the safety issues concerning anesthetic management of video-assisted thoracoscopic surgery (VATS) in pediatric patients. METHODS: The medical records of 52 pediatric patients undergoing VATS using general anesthesia and one-lung ventilation (OLV) were reviewed. OLV was achieved with a Fogarty catheter (n = 23) or endobronchial intubation (n = 7) in patients < 10 years of age (group Y, n = 30), and using a double-lumen tube (n = 19) or a univent (n = 3) in children aged between 10 and 16 years of age (group O, n = 22). Hypoxemia, hypercarbia, the difference between E(T)CO(2) and PaCO(2), and the effect of CO(2) insufflation were assessed. RESULTS: A decrease in SpO(2) less than 90% was observed in 40% of the group Y, compared to none of the group O (P < 0.05). A hypercarbia (E(T)CO(2) > 50 mmHg) was observed more frequently in group Y (40%) than in group O (0%; P < 0.05). The difference between the E(T)CO(2) and PaCO(2) was 10.4 +/- 8.9 mmHg in group Y and 4.6 +/- 3.9 mmHg in group O (P < 0.05). Hypercarbia and acidosis occurred more frequently in patients with CO(2) insufflation than those without insufflation in group Y. CONCLUSIONS: Although the anesthesia for VATS in pediatric patients was successfully accomplished, the infants and younger children presented with more intra-operative problems when compared with older children. The anesthetic management for VATS in infants and younger children requires careful and vigilant monitoring. |
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Authors:
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Hyo-Jin Byon; Ji-Won Lee; Jong-Kuk Kim; Jin-Tae Kim; Young Tae Kim; Hee-Soo Kim; Sang Chul Lee; Chong Sung Kim |
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Publication Detail:
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Type: Journal Article Date: 2010-08-20 |
Journal Detail:
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Title: Korean journal of anesthesiology Volume: 59 ISSN: 2005-7563 ISO Abbreviation: Korean J Anesthesiol Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-26 Completed Date: 2011-07-14 Revised Date: 2013-05-29 |
Medline Journal Info:
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Nlm Unique ID: 101502451 Medline TA: Korean J Anesthesiol Country: Korea (South) |
Other Details:
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Languages: eng Pagination: 99-103 Citation Subset: - |
Affiliation:
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Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea. |
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