PP:19| Volume 35, SUPPLEMENT 1, S35-S36, October 2021



      Pediatric patients with congenital heart disease suffer from respiratory problems owing to increased airway mucin production, intrinsic airway instability, tracheomalacia, bronchomalacia or due to extrinsic compression of airway caused by dilated pulmonary artery, left atrium or aorta, in the conditions like vascular rings, truncus arteriosus, total anomalous pulmonary venous connection, tetralogy of Fallot with absent pulmonary valve, etc. These can prolong ventilatory dependency of the patients Our aim was to use a holistic alternative approach to open collapsed lung in pediatric patients with congenital heart disease using simple and innovative lung recruitment technique.


      From January 2020 to March 2021, four preoperative pediatric cardiac patients having collapsed left lung, due to compression of left main bronchus, undergoing corrective cardiac surgery were subjected to lung recruitment technique by using elective endobronchial intubation and suctioning with chest physiotherapy in the form of vibration and percussion along with intermittent ventilation with 100% oxygen.


      All four patients’ collapsed lungs were opened up successfully post procedure, which was confirmed by immediate chest X rays and were successfully weaned off ventilator within 24-48 hours as per PICU protocol. One patient, who was extubated within 24 hours, had opposite lung collapse after extubation, which was managed with chest physiotherapy. Another patient had relative bradycardia (HR- 108/min) and desaturation (spo2-66%) during procedure, which was improved immediately after withdrawing tube and instituting two lung ventilations with 100% oxygen.


      Generally, flexible fibreoptic bronchoscope (FOB) is used in such type of scenario, but there are limitations of it, like non-availability of neonatal size, expertise in technique, premature and small infants, who require less than 3.5 mm size endotracheal tube, where negotiation of FOB from endotracheal tube (ETT) is not possible. This lung recruitment technique helps in improvement in lung mechanics and early weaning and shorten the duration of mechanical ventilation. It is relatively easier and safer technique one can use.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Cardiothoracic and Vascular Anesthesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect