scholarly journals “High Frequency/Small Tidal Volume Differential Lung Ventilation”: A Technique of Ventilating the Nondependent Lung of One Lung Ventilation for Robotically Assisted Thoracic Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Bassam M. Shoman ◽  
Hany O. Ragab ◽  
Ammar Mustafa ◽  
Rashid Mazhar
Keyword(s):  
Thoracic Surgery ◽  
Anesthetic Management ◽  
Lung Ventilation ◽  
Hemodynamic Instability ◽  
One Lung Ventilation ◽  
New Techniques ◽  
Respiratory Parameters ◽  
Ventilation Technique ◽  
Surgical Field ◽  
Nondependent Lung

With the introduction of new techniques and advances in the thoracic surgery fields, challenges to the anesthesia techniques had became increasingly exponential. One of the great improvements that took place in the thoracic surgical field was the use of the robotically assisted thoracic surgical procedure and minimally invasive endoscopic thoracic surgery. One lung ventilation technique represents the core anesthetic management for the success of those surgical procedures. Even with the use of effective one lung ventilation, the patient hemodynamics and respiratory parameters could be deranged and could not be tolerating the procedure that could compromise the end result of surgery. We are presenting our experience in managing one patient who suffered persistent hypoxia and hemodynamic instability with one lung ventilation for robotically assisted thymectomy procedure and how it was managed till the completion of the surgery successfully.

Congenital Pulmonary Airway Malformation

2018 ◽  
Author(s):  
Alina Lazar
Keyword(s):  
Thoracic Surgery ◽  
Anesthetic Management ◽  
Lung Ventilation ◽  
Cardiovascular Complications ◽  
Positive Pressure ◽  
Clear Understanding ◽  
One Lung Ventilation ◽  
Lung Isolation ◽  
Isolation Techniques ◽  
Lung Abnormalities

Respiratory distress in infants may be caused by perinatal events and physiologic changes (e.g., lung immaturity, meconium aspiration, and persistent pulmonary hypertension); infectious processes; cardiovascular, neurologic, and metabolic abnormalities; as well as congenital lung abnormalities. Some of these may coexist, further complicating the diagnosis, clinical course, and management of the affected infant. Sound anesthetic management of congenital lung abnormalities requires a clear understanding of the pathophysiology of lung lesions and, in particular, the consequences of positive-pressure ventilation in patients with cystic and emphysematous lesions. Also critical is an appreciation for the physiologic differences in children undergoing thoracic surgery, indications for one-lung ventilation, age-appropriate lung isolation techniques, potential respiratory and cardiovascular complications that may occur during pediatric thoracic surgery, and the optimal choices for postoperative analgesia.

scholarly journals Preoperative administration of corticosteroids in thoracic anesthesiology

2021 ◽  
Vol 25 (1) ◽  
pp. 94-96
Author(s):  
O. Sydiuk ◽  
A. Sydiuk ◽  
A. Klimas ◽  
G. Savenko
Keyword(s):  
Thoracic Surgery ◽  
Postoperative Period ◽  
Lung Ventilation ◽  
Peripheral Blood Lymphocytes ◽  
One Lung Ventilation ◽  
Proinflammatory Response ◽  
Flow Cytofluorometry ◽  
Preoperative Administration ◽  
Surgical Field ◽  
And Control

Annotation. One lung ventilation (OLV) is one of the most difficult intraoperative methods of respiratory support for anesthesiologists. OLV should provide the most comfortable surgical field, maintaining proper gas exchange and minimizing damage to both lungs. This anesthetic procedure has a significant inflammatory response, so using perioperative corticosteroid therapy to suppress inflammatory mediators is recommended as an approach to improving prognosis. Therefore, the aim of this study was to determine how the preoperative administration of methylprednisolone affects the systemic proinflammatory response of cytokines during thoracic surgery. The analysis was performed for 80 patients who underwent surgeries in the thoraco-abdominal department of the Shalimov National Institute of Surgery and Transplantology. Patients were divided into 2 groups (study – 40 patients who were administered methylprednisolone 10 mg / kg intravenously during induction of anesthesia and control – 40 patients without methylprednisolone). Before surgery and in the postoperative period on days 1, 3 and 5, the surface phenotype of peripheral blood lymphocytes and the expression of IL-6 by monocytes were determined by flow cytofluorometry. The author's MedStat package was used for statistical analysis (Lyakh Yu.E., Guryanov V.G., 2004–2012). Postoperative indicators of IL-6 monocyte expression in the blood of patients administered methylprednisolone were significantly lower on the 1st and 3rd postoperative day (p<0.001). Thus, preoperative administration of methylprednisolone reduces the release of pro-inflammatory cytokines and improves the condition of patients after thoracic surgery. We consider it expedient to conduct further research on the administration of methylprednisolone for several days in the postoperative period.

Robotic Thoracic Surgery

2019 ◽  
pp. 289-295
Author(s):  
D. Keegan Stombaugh ◽  
Allison Dalton
Keyword(s):  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Lung Ventilation ◽  
Wound Complications ◽  
One Lung Ventilation ◽  
Double Lumen Endotracheal Tube ◽  
Improved Outcomes ◽  
Surgical Field ◽  
Minimally Invasive Thoracic Surgery ◽  
Video Assisted Thoracoscopic Surgery

Minimally invasive thoracic surgery has improved outcomes, including reduced length of postoperative admission, reduced postoperative pain, shorter postoperative stay, reduced wound complications, reduced blood loss, improved cosmesis, and improved equivalent oncological outcomes compared to traditional thoracotomy. Robotic thoracic surgery (RTS) is an improvement on video-assisted thoracoscopic surgery in that it allows the surgeon a greater degree of freedom with instrument movement and better surgical field visualization. Thoracic insufflation and one-lung ventilation both significantly alter and compromise the patient’s baseline cardiopulmonary physiology. Due to this, adequate preoperative workup, deftness at double-lumen endotracheal tube management, and advanced understanding of how RTS affects cardiopulmonary physiology are essential.

scholarly journals May awake video-assisted thoracoscopic surgery with thoracic epidural anesthesia use routinely for minimaly invasive thoracic surgery procedures in the future?

2018 ◽  
Vol 5 (5) ◽  
pp. 1602
Author(s):  
Gonul Sagiroglu ◽  
Fazli Yanik ◽  
Yekta A. Karamusfaoglu ◽  
Elif Copuroglu
Keyword(s):  
Thoracic Surgery ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Thoracoscopic Surgery ◽  
Lung Ventilation ◽  
Thoracic Epidural Anesthesia ◽  
One Lung Ventilation ◽  
Thoracic Epidural ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Background: In the last years thoracic surgery developed in greater extent with equipments and techniques in one lung ventilation. Still general anesthesia in one lung ventilation approved as gold standard. In thoracic surgery most performed surgeries are plerural decortication and lung biopsy. Avoidance of intubation in Video Assisted Thoracoscopic Surgery (VATS) procedures gains us some advantages in postoperative period; a better respiratory parameters, survival and morbidity mortality rates, reduced hospitalization time and costs, reduced early stress hormone and immune response.  Methods: In this study, we reported our experience of 24 consecutive patients undergoing VATS with Thoracic Epidural Anesthesia (TEA) between December 2015 through July 2016 to evaluate the feasibility, safety and indication of this innovative technique whether it will be a gold standart in thoracic surgeries or not in the future.Results: Operation procedures included wedge resection in 11 (46%) patients (eight of them for pneumothorax, three of them for diagnosis), in 10 (42%) patients pleural biopsy (eight of them used talc pleurodesis), in two (8%) patients air leak control with fibrin glue and in one (4%) patient bilateral thoracal sympathectomy for hyperhidrosis.  We used T4-5 TEA space for 17 (72%) of patients, while we used T4-6 TEA space for 7 (28%) of patients. TEA block reached the desired level after the mean 26.4±4.3 minutes (range 21-34 min). There was no occurrence of hypotension and bradycardia during and after TEA. One (4%) patient required conversion to general anesthesia and tracheal intubation because of significant diaphragmatic contractions and hyperpne. Conversion to thoracotomy was not needed in any patient.Conclusions: We conclude that nVATS procedure with aid of TEA is feasibile and safety with minimal adverse events. The procedure can have such advantages as early mobilization, opening of early oral intake, early discharge, patient satisfaction, low pain level. Nevertheless, there is a need for randomized controlled trials involving wider case series on the subject.

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