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The use of high-frequency oscillating ventilation to facilitate stability during neonatal thoracoscopic operations.

Publication ,  Journal Article
Mortellaro, VE; Fike, FB; Adibe, OO; Juang, D; Aguayo, P; Ostlie, DJ; Holcomb, GW; St Peter, SD
Published in: J Laparoendosc Adv Surg Tech A
November 2011

BACKGROUND: Thoracoscopy has become a surgical option for the repair of esophageal atresia (EA) and congenital diaphragmatic hernia (CDH). Insufflation of carbon dioxide combined with one lung ventilation creates an anesthetic challenge to control acidosis and maintain oxygenation while allowing optimal operative exposure. We have overcome these issues by utilizing the high-frequency oscillating ventilator (HFOV) and report our early experience. METHODS: A retrospective review from 2007 to 2010 on neonates who underwent thoracoscopic operation utilizing HFOV. Patient demographics and intraoperative course were reviewed. RESULTS: Seventeen neonates were identified, 12 with EA and 5 with posterolateral CDH. The median age at operation was 4 days (range 1-166 days), with a median weight of 2.9 ± 1.0 kg. Median gestational age was 38 ± 3 weeks. Before surgery, 6 patients (35%) were on conventional mechanical ventilation, and no patient was on high-frequency oscillating ventilation. Median American Society of Anesthesiologist's score was 3 (range 3-4). There were no intraoperative complications and median operative time was 208 ± 72 minutes. Review of the operative reports identified no significant difficulties with exposure of the operative field in all patients. Median ventilator manipulations needed were 3 per case. Mean intraoperative pulse oximetry was 97% ± 2%. Sixteen patients had intraoperative arterial blood gases; 1 had venous sampling. Patients with arterial blood gases had a mean pH of 7.36 (range 7.18-7.47), mean pCO2 was 41 mmHg (range 25-63 mmHg), and mean pO2 was 156 mm Hg (range 41-426 mmHg). CONCLUSION: Usage of HFOV allows for good intraoperative exposure with excellent oxygenation and elimination of carbon dioxide to prevent acidosis.

Duke Scholars

Published In

J Laparoendosc Adv Surg Tech A

DOI

EISSN

1557-9034

Publication Date

November 2011

Volume

21

Issue

9

Start / End Page

877 / 879

Location

United States

Related Subject Headings

  • Thoracoscopy
  • Surgery
  • Retrospective Studies
  • Pediatrics
  • Oximetry
  • Infant, Newborn
  • Infant
  • Hydrogen-Ion Concentration
  • Humans
  • High-Frequency Ventilation
 

Citation

APA
Chicago
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MLA
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Mortellaro, V. E., Fike, F. B., Adibe, O. O., Juang, D., Aguayo, P., Ostlie, D. J., … St Peter, S. D. (2011). The use of high-frequency oscillating ventilation to facilitate stability during neonatal thoracoscopic operations. J Laparoendosc Adv Surg Tech A, 21(9), 877–879. https://doi.org/10.1089/lap.2011.0134
Mortellaro, Vincent E., Frankie B. Fike, Obinna O. Adibe, David Juang, Pablo Aguayo, Daniel J. Ostlie, George W. Holcomb, and Shawn D. St Peter. “The use of high-frequency oscillating ventilation to facilitate stability during neonatal thoracoscopic operations.J Laparoendosc Adv Surg Tech A 21, no. 9 (November 2011): 877–79. https://doi.org/10.1089/lap.2011.0134.
Mortellaro VE, Fike FB, Adibe OO, Juang D, Aguayo P, Ostlie DJ, et al. The use of high-frequency oscillating ventilation to facilitate stability during neonatal thoracoscopic operations. J Laparoendosc Adv Surg Tech A. 2011 Nov;21(9):877–9.
Mortellaro, Vincent E., et al. “The use of high-frequency oscillating ventilation to facilitate stability during neonatal thoracoscopic operations.J Laparoendosc Adv Surg Tech A, vol. 21, no. 9, Nov. 2011, pp. 877–79. Pubmed, doi:10.1089/lap.2011.0134.
Mortellaro VE, Fike FB, Adibe OO, Juang D, Aguayo P, Ostlie DJ, Holcomb GW, St Peter SD. The use of high-frequency oscillating ventilation to facilitate stability during neonatal thoracoscopic operations. J Laparoendosc Adv Surg Tech A. 2011 Nov;21(9):877–879.
Journal cover image

Published In

J Laparoendosc Adv Surg Tech A

DOI

EISSN

1557-9034

Publication Date

November 2011

Volume

21

Issue

9

Start / End Page

877 / 879

Location

United States

Related Subject Headings

  • Thoracoscopy
  • Surgery
  • Retrospective Studies
  • Pediatrics
  • Oximetry
  • Infant, Newborn
  • Infant
  • Hydrogen-Ion Concentration
  • Humans
  • High-Frequency Ventilation