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. 2022 Jun 15:9:869771.
doi: 10.3389/fmed.2022.869771. eCollection 2022.

Ultrasound-Guided Selective Bronchial Intubation: A Feasibility Study in Pediatric Animal Model

Sara Hora Gomes  1   2 , Alice Miranda  1   2 , José Miguel Pêgo  1   2 , Patrício S Costa  1   2 , Jorge Correia-Pinto  1   2   3
Affiliations

Ultrasound-Guided Selective Bronchial Intubation: A Feasibility Study in Pediatric Animal Model

Sara Hora Gomes et al. Front Med (Lausanne). .

Abstract

Objective: Selective one-lung ventilation used to optimize neonatal and pediatric surgical conditions is always a demanding task for anesthesiologists, especially during minimally invasive thoracoscopic surgery. This study aims to introduce an ultrasound-guided bronchial intubation and exclusion technique in a pediatric animal model.

Methods: Seven rabbits were anesthetized and airway ultrasound acquisitions were done.

Results: Tracheal tube progression along the trachea to the right bronchus and positioning of the bronchial blocker in the left bronchus were successfully done with consistent ultrasound identification of relevant anatomical structures.

Conclusion: The study provided a new application of ultrasound in airway management. More advanced experimental studies are needed since this technique has the potential for translation to pediatric anesthesia.

Keywords: bronchial exclusion; bronchial intubation; pediatric animal model; selective; ultrasound-guided.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Transverse plane of the trachea at the middle cervical level. A – Trachea, C – Carotid artery, E – Esophagus.
FIGURE 2
FIGURE 2
Transverse plane of the trachea at the caudal cervical level at the inlet of the thoracic cage. A – Trachea, B – Clavicle bone, C – Common Carotid artery, E – Esophagus.
FIGURE 3
FIGURE 3
Longitudinal plane of cervical trachea. ATI, air-tissue interface.
FIGURE 4
FIGURE 4
Oblique, parasternal, and midclavicular plane of the thoracic trachea. A – trachea, LC, Left common carotid artery, BCA, brachiocephalic or innominate artery. Part 1 – more cephalic view. Part 2 – more caudal view, at the level of the brachiocephalic artery.
FIGURE 5
FIGURE 5
Longitudinal anterior plane of the neck. RT, reinforced tracheal tub.
FIGURE 6
FIGURE 6
Oblique, parasternal, and midclavicular plane 1. Bronchial blocker in the left bronchus. BB, Bronchial blocker, LB, Left bronchus. 2. Reinforced tube in the right bronchus. RT, Reinforced tube, RB, Right Bronchus, LA, left atrium, RA, right atrium.
See this image and copyright information in PMC

References

    1. Cohen DE, McCloskey JJ, Motas D, Archer J, Flake AW. Fluoroscopic-assisted endobronchial intubation for single-lung ventilation in infants. Paediatr Anaesth. (2011) 21:681–4. 10.1111/j.1460-9592.2011.03585.x - DOI - PubMed
    1. Narayanasamy S, Adler E, Mahmoud M, Burkley M, Lim FY, Subramanyam R. Airway management of congenital pulmonary airway malformation resection in neonates and infants: a case cohort study. Paediatr Anaesth. (2019) 29:808–13. 10.1111/pan.13648 - DOI - PubMed
    1. Fabila TS, Menghraj SJ. One lung ventilation strategies for infants and children undergoing video assisted thoracoscopic surgery. Indian J Anaesth. (2013) 57:339–44. 10.4103/0019-5049.118539 - DOI - PMC - PubMed
    1. Letal M, Theam M. Paediatric lung isolation. BJA Educ. (2017) 17:57–62.
    1. Templeton TW, Piccioni F, Chatterjee D. An update on one-lung ventilation in children. Anesth Analg. (2021) 132:1389–99. 10.1213/ANE.0000000000005077 - DOI - PubMed

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