The therapeutic potential of intraoperative hypercapnia during video-assisted thoracoscopy in pediatric patients.

Background: Although the cardiovascular effect of CO2 insufflation has not been reported in pediatric thoracoscopy, several clinical trials have demonstrated significant hemodynamic deterioration in adults. We investigated the concept of therapeutic hypercapnia for counteracting the hemodynamic effect of induced capnothorax.

Methods: Twelve pediatric patients who underwent video-assisted thoracoscopic patent ductus arteriosus closure were enrolled in the study.

Unusual complication during pediatric thoracoscopy.

A small infant with congenital cystic adenomatoid was scheduled for thoracoscopic resection of the lung cyst. During carbon dioxide insufflation, there was a sharp rise of endtidal carbon dioxide which was followed by marked hypoxemia and bradycardia due to occlusion of the tracheal tube with blood. The plan changed to open thoracotomy and total pneumonectomy.