Pediatric anesthesia & critical care
Positive End-Expiratory Pressure and Atelectasis after Bronchial Blockade One-Lung Ventilation in Infants: A Randomized Controlled Study
Authors' conclusion
In one-lung ventilation using bronchial blockers performed during thoracoscopic lobectomies in infants, applying PEEP at 5 to 6 cmH2O combined with 100% oxygen ventilation after the removal of the bronchial blocker until extubation was associated with improved oxygenation and did not appear to increase the risk of atelectasis during emergence from anesthesia.
Study context
- Population
- Infants <1 year, American Society of Anesthesiologists (ASA) I–II, with congenital cystic adenomatoid malformation undergoing thoracoscopic lobectomy with bronchial blocker one-lung ventilation (OLV)
- Participants
- 69 vs 69
- Comparison
- Group A vs Group B
- Group An = 69reference
- Group Bn = 69
- Primary endpoint
- Atelectasis during emergence from anesthesia
Methodological detailssingle teaching hospital, Infants operated June 2024 to December 2024
- Single teaching hospital
- Infants operated June 2024 to December 2024
Primary result
As reported in the abstract
- Proportions with lung ultrasound scores of 3 and chest radiography atelectasis scores of 3 lower in Group B vs Group A
- p < 0.05
Further findings
Hypoxemia after extubation (SpO2 < 90%)
P < 0.05
Oxygenation index, alveolar-arterial oxygen differential pressure, SpO2 at completion of surgery (T1)
- No significant differences between groups
- P > 0.05
Oxygenation index, PaO2, alveolar-arterial oxygen differential pressure, lowest SpO2 within 30 min after extubation · T2 (30 minutes after extubation)
- Oxygenation index and PaO2 greater, alveolar-arterial difference lower, lowest SpO2 better in Group B vs Group A
- P < 0.05
Time from bronchial blocker removal to extubation
- Shorter in Group B than in Group A
- P < 0.05
Duration of oxygen administration after extubation
- Shorter in Group B than in Group A
- P < 0.05
Perioperative hemodynamics, duration of operation, postoperative hospital LOS
- No significant differences between groups
- P > 0.05
Correlation of lung ultrasound scores with chest radiographic atelectasis score
- Statistically significant correlation in both groups
- P < 0.05
Original publication
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