Single-Lung Ventilation in Infants for Surgical Repair of Coarctation of The Aorta Without Cardiopulmonary Bypass

TL;DR

Using single-lung ventilation during infant aorta surgery improves surgical visibility and reduces complications without cardiopulmonary bypass.

Contribution

Demonstrates the benefits of single-lung ventilation in infant aortic surgery without cardiopulmonary bypass.

Findings

Single-lung ventilation improved surgical exposure and reduced postoperative atelectasis.

Infants with single-lung ventilation had shorter operation and ICU stay durations.

No significant differences in preoperative or intraoperative vital signs between groups.

Abstract

To investigate the effect of improving the operative field and postoperative
atelectasis of single-lung ventilation (SLV) in the surgical repair of
coarctation of the aorta (CoA) in infants without the use of cardiopulmonary
bypass (CPB).

This was a retrospective cohort study. The clinical data of 28 infants (aged
1 to 4 months, weighing between 4.2 and 6 kg) who underwent surgical repair
of CoA without CPB from January 2019 to May 2022 were analyzed. Fourteen
infants received SLV with a bronchial blocker (Group S), and the other 14
infants received routine endotracheal intubation and bilateral lung
ventilation (Group R).

In comparison to Group R, Group S exhibited improved exposure of the
operative field, a lower postoperative atelectasis score (P<0.001),
reduced prevalence of hypoxemia (P=0.01), and shorter durations of
operation, mechanical ventilation, and ICU stay (P=0.01, P<0.001,
P=0.03). There was no difference in preoperative information or
perioperative respiratory and circulatory indicators before SLV, 10 minutes
after SLV, and 10 minutes after the end of SLV between the two groups
(P>0.05). Intraoperative bleeding, intraoperative positive end-expiratory
pressure (PEEP), and systolic pressure gradient across the coarctation after
operation were also not different between the two groups (P>0.05).

This study demonstrates that employing SLV with a bronchial blocker is
consistent with enhanced operative field, reduced operation duration, lower
prevalence of intraoperative hypoxemia, and fewer postoperative
complications during the surgical repair of CoA in infants without the use
of CPB.

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