Bronchial Blocker Versus Endobronchial Intubation in Young Children Undergoing One-Lung Ventilation: A Multicenter Retrospective Cohort Study.

Background: Thoracic surgery and one-lung ventilation in young children carry significant risks. Approaches to one-lung ventilation in young children include endobronchial intubation (mainstem intubation) and use of a bronchial blocker. We hypothesized that endobronchial intubation is associated with a greater prevalence of airway complications compared to use of a bronchial blocker.

A Practical Guide for Using the EZ-Blocker Endobronchial Blocker: Tips and Tricks After 10 Years of Experience.

The EZ-Blocker (EZB) is a "Y-shaped," semirigid endobronchial blocker used for lung isolation and one-lung ventilation during thoracic surgery. Like many medical tools, initial efforts to use this endobronchial blocker may prove challenging for the uninitiated. However, some tips and tricks can be applied fairly rapidly to aid the clinician in properly placing the device, and, furthermore, may help the clinician get the most out of this innovative device.

Risk factors for administration of additional reversal following neuromuscular blockade with rocuronium in children: A retrospective case-control study.

Background: The prevalence and risk factors for residual neuromuscular blockade in children remain poorly characterized. We hypothesize that specific patient and anesthetic risk factors may be associated with the administration of additional reversal in children following initial reversal of rocuronium with neostigmine.

Methods: Our electronic health record was queried for patients <18 years of age who received rocuronium and reversal with neostigmine from 2017 through 2020.

It's Not Over Till It's Over: A Prospective Cohort Study and Analysis of "Anesthesia Stat!" Emergency Calls in the Pediatric Post-Anesthesia Care Unit (PACU).

Background Emergency "Anesthesia Stat!" (AS!) calls remain a common practice in medical centers even when advanced communication infrastructures are available. We hypothesize that the analysis of post-procedure "AS!" calls will lead to actionable insights which may enhance patient safety. Methods After institutional review board approval, we prospectively collected data from April 2015 through May 2018 on "AS!" calls throughout the pediatric operating rooms (OR), off-site locations, and post-anesthesia care unit (PACU) at a tertiary university medical center.

Hypoxemia in Young Children Undergoing One-lung Ventilation: A Retrospective Cohort Study.

Background: One-lung ventilation in children remains a specialized practice with low case numbers even at tertiary centers, preventing an assessment of best practices. The authors hypothesized that certain case factors may be associated with a higher risk of intraprocedural hypoxemia in children undergoing thoracic surgery and one-lung ventilation.

Methods: The Multicenter Perioperative Outcomes database and a local quality improvement database were queried for documentation of one-lung ventilation in children 2 months to 3 yr of age inclusive between 2010 and 2020.

Endobronchial Intubation to Facilitate Extraluminal Bronchial Blocker Placement in Young Children: A Retrospective Case Series.

Objectives: Extraluminal bronchial blocker placement has become a well-accepted approach to one-lung ventilation in young children. In some cases, technical issues with placement may require alternative approaches to correct bronchial blocker positioning. The primary aim of this study was to review the authors' experience with using endobronchial intubation to facilitate extraluminal bronchial blocker placement in young children.

Bronchial Blocker Entrapment in a 7-Month-Old Infant: A Case Report.

We present the case of a 7-month-old infant undergoing thoracotomy and left lower lobe lobectomy who experienced a significant complication related to lung isolation with a bronchial blocker. Despite good isolation and seemingly appropriate positioning, the bronchial blocker became entrapped within the staple line at the bronchial stump. Fortunately, the surgeon was able to free the blocker.

Experience with a "Feed and Swaddle" program in infants up to six months of age.

Background: Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique and with comparable patients imaged under anesthesia.

Methods: We reviewed the charts of all infants ≤6 months who underwent brain MRI at our institution between 1 January 2013 and 31 March 2016.

Assessment of Common Criteria for Awake Extubation in Infants and Young Children.

Background: Practice patterns surrounding awake extubation of pediatric surgical patients remain largely undocumented. This study assessed the value of commonly used predictors of fitness for extubation to determine which were most salient in predicting successful extubation following emergence from general anesthesia with a volatile anesthetic in young children.

Methods: This prospective, observational study was performed in 600 children from 0 to 7 yr of age.

A generalized multistage approach to oral and nasal intubation in infants with Pierre Robin sequence: A retrospective review.

Background: Airway management in children with Pierre Robin sequence in the infantile period can be challenging and frequently requires specialized approaches.

Aims: The aim of this study was to review our experience with a multistage approach to oral and nasal intubation in young infants with Pierre Robin sequence.

Methods: After IRB approval, we reviewed 13 infants with Pierre Robin sequence who underwent a multistage approach to intubation in the operating room for mandibular distractor or gastrostomy tube placement.

An initial experience with an Extraluminal EZ-Blocker : A new alternative for 1-lung ventilation in pediatric patients.

Background: The need for 1-lung ventilation in school age, pediatric patients is uncommon and as a result there are relatively few devices available to facilitate lung isolation in this population. Furthermore, little is known about the efficacy and techniques of placement of the currently available devices. One of the newest devices available that may be appropriate in this age group is the EZ-Blocker.

A comparison of 3 ventilation strategies in children younger than 1 year using a Proseal laryngeal mask airway: a randomized controlled trial.

Study Objective: To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in patients younger than 1 year with a ProSeal laryngeal mask airway (PLMA).

Design: Randomized prospective study.

Setting: Tertiary care pediatric hospital.

Comparing 3 ventilation modalities by measuring several respiratory parameters using the ProSeal laryngeal mask airway in children.

Study Objective: To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in pediatric patients with a ProSeal laryngeal mask airway (PLMA).

Design: Randomized prospective study.

Setting: Pediatric hospital of a tertiary care academic medical center.

Bending the rules: a novel approach to placement and retrospective experience with the 5 French Arndt endobronchial blocker in children <2 years.

Background: One-lung ventilation (OLV) is frequently employed to improve surgical exposure during video-assisted thoracoscopic surgery (VATS) and thoracotomy in adults and children. Because of their small size, children under the age of 2 years are not candidates for some of the methods typically used for OLV in adults and older children, such as a double-lumen endotracheal (DLT) tube or intraluminal use of a bronchial blocker. Due to this, the clinician is left with few options.