Comparison of Stepwise Lung Recruitment with Conventional Technique on Lung Function During One-Lung Ventilation in Infants Undergoing Segmental Lung Resection.

OBJECTIVE

Thoracoscopic segmental lung resection utilizes one-lung ventilation (OLV) to isolate and safeguard the lung while enhancing surgical field visibility. This study aimed to assess the protective influence of stepwise lung recruitment maneuvers on lung function in infants undergoing OLV during thoracoscopic segmental lung resection.

METHODS

A total of 78 pediatric patients who were slated for elective general anesthesia and segmental lung resection via thoracoscopy were randomly allocated to either the stepwise lung recruitment group (SR group) or the controlled lung expansion group (CR group). The study meticulously documented several key variables, including duration of one-lung ventilation, duration of surgical procedure, amount of blood loss, and volume of intraoperative fluid replacement.

RESULTS

The following did not exhibit any statistically significant differences between the two groups: anesthesia time, surgery time, one-lung ventilation time, and fluid replacement volume (P > 0.05). At T1, the experimental group showed lower peak airway pressure and higher levels of Pmean, Cdyn, OI, and VT compared to the control group [(19.79±1.52) vs (16.48±1.47), (4.32±0.63) vs (3.11±0.49), (177.09±17.34) vs (130.64±15.78), (309.83±20.25) vs (286.21±18.63)]; all differences were statistically significant (P < 0.05). In contrast to the CR group, the SR group exhibited a reduced occurrence of pneumonia, atelectasis, and pneumothorax (P < 0.05).

CONCLUSION

Stepwise lung recruitment confers protective benefits on lung function in pediatric patients and concurrently diminishes the incidence of pulmonary complications.