One-lung ventilation management for thoracic surgeries in pediatric oncology

L.A. Martynov1, N.V. Matinyan1,2

1 Pediatric Oncology and Hematology Research Institute, Blokhin Russian Cancer Research Center of the Ministry of Health of Russia, Moscow

2 Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Moscow

For correspondence: Nune Matinyan — MD, PhD, Professor, Head of Anesthesiology and intensive care department, Pediatric Oncology and Hematology Research Institute, Blokhin Russian Cancer Research Center of the Ministry of Health of Russia, Moscow; e-mail: n9031990633@ya.ru

For citation: Martynov L.A., Matinyan N.V. One-lung ventilation management for thoracic surgeries in pediatric oncology. Alexander Saltanov Intensive Care Herald. 2018;4:65–73.

DOI: 10.21320/1818-474X-2018-4-65-73


Treatment of children with mediastinal and lung tumors is an urgent problem in both surgery and anesthesiology. Main goal is to grant optimal conditions for the surgery — collapse of the lung on the side of the operation, while maintaining adequate oxygenation and efficient transport of oxygen to the tissues. The choice of devices for carrying out one-lung ventilation is the most important factor determining the safety of the patient.

Aim. To increase the efficiency and safety of anesthesia for thoracic surgeries in children due to the use of bronchial blockers for one-lung ventilation.

Materials and methods. 70 surgeries were performed (38 — thoracoscopic, 32 — thoracotomies) in 70 patients. Patients were randomly divided into two groups: Study Group (BB) (n = 56) — one-lung ventilation was performed using bronchial blocker; Control group (DLT) (n = 14) — one-lung ventilation was performed using a double-lumen tube. Ventilation parameters, hemodynamics, the incidence of complications in the perioperative and postoperative periods were recorded.

Results. A much less prolonged intubation of the trachea time in BB group was found compared to the DLT group (55.36 ± 26.34 sec versus 97.0 ± 7.09 sec, respectively, p < 0.0001) and a lower frequency of repositioning (0.2 ± 0.4 and 0.57 ± 0.51, respectively, p = 0.04). In patients with bronchial blockers, less complications were recorded, such as postoperative aphonia and sore throat.

Conclusion. An analysis of obtained results allows the assertion that bronchial blockers demonstrate greater efficacy in comparison with double-lumen tubes. They provide faster intubation than DLT, irrespective of the side of the surgery, allow complete collapse of the lung with a less frequent need for repositioning. The introduction of a new method of one-lung ventilation with the use of bronchial blockers in children will improve the results of surgeries by providing adequate conditions for the surgical team, reducing the length of stay of patients in the intensive care unit during the postoperative period due to the reduction in complications such as trauma of the main bronchi, aphonia and sore throat.

Keywords: pediatric oncology, thoracic surgery, one lung ventilation, bronchial blockers

Received:  15.10.2018


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Use of Presepsin and Nitric Oxide Metabolites in Pediatric Oncology Patients with Infectious Complications

E.G. Golovnya, A.V. Sotnikov, V.N. Baykova, O.P. Petina

N.N. Blokhin Russian Cancer Research Center, Moscow

For correspondence: Sotnikov Anatoly Bjacheslavovich — Ph.D, Senior Research Officer, Department of anesthesiology and reanimatology of N.N. Blokhin Russian Cancer Research Center; e-mail: abcv@mail.ru

For citation: Golovnya EG, Sotnikov AV, Baykova VN, Petina OP. Use of presepsin and nitric oxide metabolites in pediatric oncology patients with infectious complications. Intensive Care Herald. 2016;3:43–46.


Early diagnostics of infectious complications is an actual problem of modern medicine. Application of different methods of laboratory biomarkers of sepsis allows to differentiate between different pathological conditions by its severity (from SIRS to septic shock and multi-organ failure), that seems to be crucial in prognosis. Differences in concentration of presepsin (PSP) and nitric oxide metabolites (sum of nitrates and nitrites) in two groups of pediatric patient with oncological diseases are presented in current research (р < 0.05). There was no statistically significant correlation between these biomarkers in both groups of patients. Our data showed evidence that growth of concentration of PSP and simultaneous drawdown of concentration of NOx could be a factor of poor prognosis in patients with infectious complications.

Keywords: biomarkers of sepsis, pediatric oncology, presepsin, nitric oxide

Received: 06.03.2016


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