Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2012
Single-lung ventilation with carbon dioxide hemipneumothorax: hemodynamic and respiratory effects in piglets.
Video-assisted thoracoscopic surgery (VATS) has become a standard procedure in pediatric surgery. To facilitate surgical access, the dependent lung has to collapse using intrathoracic carbon dioxide insufflation and/or single-lung ventilation. These procedures can induce hemodynamic deteriorations in adults. The potential impacts of single-lung ventilation in combination with capnothorax on hemodynamics in infants have never been studied before. ⋯ Despite a decrease in CI and preload parameters, the combination of single-lung ventilation and low-pressure capnothorax was well tolerated in piglets and could justify further clinical studies to be performed in infants and children focusing on hemodynamic and respiratory changes during VATS.
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Coaxial tomography (CT) and magnetic resonance imaging (MRI) scans are so much part of neurological investigation these days and provide such detailed information that even thorough neurological clinical examination may be neglected. The investigations in common use forty years ago were pneumoencephalography, ventriculography in babies with hydrocephalus, and carotid angiography with the injection of X-ray contrast to outline the arteries.