REVIEW ARTICLE
Year : 2021  |  Volume : 15  |  Issue : 4  |  Page : 424-427

When to abandon single-lung anesthesia during video-assisted thoracoscopic surgery (VATS) in infants and young children: A case-based review


Department of Anesthetics, King's College Hospital NHS Trust, Denmark Hill, London, United Kingdom

Correspondence Address:
Chulananda Goonasekera
Consultant Anesthetist, Department of Anesthetics, King's College Hospital NHS Trust, Denmark Hill, London SE5 9RS
United Kingdom
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.sja_171_21

Rights and Permissions

Video-assisted thoracoscopic surgery (VATS) in infants and young children increasingly require one-lung anesthesia. However, the maintenance of norms of gas exchange is difficult during one-lung anesthesia in some infants. A combination of factors including added dead space of HME and the circle Y piece, intrathoracic inflation of CO2 and its pressure, airway resistance and bilateral lung disease contribute. Seeping blood from the operating lung soiling the endobronchial tube causes airway narrowing and obstruction adding to this difficulty especially during prolonged thoracoscopy. We report two cases: hypoxemia in one and hypercapnia in the other. Guidance on safe limits of permissive hypoxemia or hypercarbia in this scenario is vague. Therefore, irreversible hypoxemia and hypercarbia with changes in acid–base status should be considered as indications for swift conversion to open thoracotomy and abandon one-lung ventilation.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed341    
    Printed8    
    Emailed0    
    PDF Downloaded73    
    Comments [Add]    

Recommend this journal