The application of one-lung ventilation in open heart surgery through right subaxillary minimally invasive small incision in infants
10.3969/j.issn.1006-5725.2015.15.037
- VernacularTitle:单肺通气在婴幼儿腋下小切口心内直视手术中的应用
- Author:
Zhengbing ZHANG
;
Teng MING
- Publication Type:Journal Article
- Keywords:
OLV;
Open heart surgery;
Minimally invasive small incision;
Infants
- From:
The Journal of Practical Medicine
2015;31(15):2524-2526
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate theeffect of the one-lung ventilation (OLV) on open heart surgery with right subaxillary minimally invasive small incision in infants. Methods We conducted a retrospective analysis of 316 infants undergoing open heart surgery through right axillary straight mini-thoracotomy in ourhospital from Jan-uary 2014 to December 2014. Ordinary tracheal tube was inserted into left bronchus during OVL in all patients. OLV with pressure-control mode was performed with FiO2 100% and I:E 1:1 ~ 1.5 and their respiratory rate and the pressure ventilation were adjusted to maintain SpO2 and ETCO2 in the normal range. Conventional ultrafiltration was performed after CPB and fluid restrictions were intraoperatively maintained. Blood samples were obtained for deter-mination of PaO2 and PaCO2 after induction of anesthesia (T1), at the time points: OLV 10 min (T2), OLV 30 min (T3), OLV10 min after CPB (T4) and the recovery TVL (T5). The HR, MAP, incidence of pneumothorax and me-chanical ventilation time were recorded and monitored as well. Result All patients lived through perioperative pe-riod, without pneumothorax. There were no significant differences in PaCO2, HR and MAP between time points. But PaO2 at the time point of T1 significantly lowerthan those at other time points of T2, T3, T4 and T5, but its indexes at all time points were in normal range. Conclusion The appropriate skills ofintubation, rational strategy of ventila-tion and intensive prevention of the lung may be good for the safe application of OVL in open heart surgery through right subaxillary minimally invasive small incision in infants.
