High-Frequency Jet Ventilation for Resection of Congenital Lobar Emphysema

Gotô, Hiroshi; Boozalis, Steve T.; Benson, Kirk T.; Arakawa, Kasumi

doi:10.1213/00000539-198707000-00022

Cited by 32 publications

(19 citation statements)

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“…It is suggested that airway pressures be maintained at <20–25 cm H 2 O 7–9. However, prolonged preoperative ventilation has been described,10 as has utilisation of high frequency ventilation with minimal airway pressures 11…”

Section: Discussionmentioning

confidence: 99%

Congenital lobar emphysema: diagnostic and therapeutic challenges

et al. 2016

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Congenital lobar emphysema (CLE), a rare condition that usually presents in the neonatal period, can be a diagnostic and therapeutic challenge for the treating clinician. If unrecognised, it is a significant risk at the time of anaesthetic induction. We describe a case of CLE in a 3-month-old boy who was initially treated for suspected aspiration pneumonia at the referring hospital. We highlight the importance of careful consideration of common childhood respiratory illness as well as pneumothorax in the differential diagnosis, and the significance of appropriate preoperative anaesthetic management. We also emphasise the importance of acknowledging a mother's concerns when taking a paediatric history.

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Section: Discussionmentioning

confidence: 99%

Congenital lobar emphysema: diagnostic and therapeutic challenges

et al. 2016

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“…In such cases, some authors have suggested the use of high-frequency ventilation,( 23 ) selective intubation,( 24 ) or endoscopic decompression of the emphysematous lobe( 25 ) for preoperative and perioperative optimization. In cases in which the onset of symptoms is after the sixth month of life or in oligosymptomatic patients, conservative treatment is an option and has been widely discussed in the literature.…”

Section: Discussionmentioning

confidence: 99%

Congenital lobar emphysema: 30-year case series in two university hospitals

et al. 2013

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OBJECTIVE: To review the cases of patients with congenital lobar emphysema (CLE) submitted to surgical treatment at two university hospitals over a 30-year period. METHODS: We reviewed the medical records of children with CLE undergoing surgical treatment between 1979 and 2009 at the Botucatu School of Medicine Hospital das Clínicas or the Mogi das Cruzes University Hospital. We analyzed data regarding symptoms, physical examination, radiographic findings, diagnosis, surgical treatment, and postoperative follow-up. RESULTS: During the period studied, 20 children with CLE underwent surgery. The mean age at the time of surgery was 6.9 months (range, 9 days to 4 years). All of the cases presented with symptoms at birth or during the first months of life. In all cases, chest X-rays were useful in defining the diagnosis. In cases of moderate respiratory distress, chest CT facilitated the diagnosis. One patient with severe respiratory distress was misdiagnosed with hypertensive pneumothorax and underwent chest tube drainage. Only patients with moderate respiratory distress were submitted to bronchoscopy, which revealed no tracheobronchial abnormalities. The surgical approach was lateral muscle-sparing thoracotomy. The left upper and middle lobes were the most often affected, followed by the right upper lobe. Lobectomy was performed in 18 cases, whereas bilobectomy was performed in 2 (together with bronchogenic cyst resection in 1 of those). No postoperative complications were observed. Postoperative follow-up time was at least 24 months (mean, 60 months), and no late complications were observed. CONCLUSIONS: Although CLE is an uncommon, still neglected disease of uncertain etiology, the radiological diagnosis is easily made and surgical treatment is effective.

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“…[9,11,14] There are few other novel techniques described to manage such patients. Goto et al [15] have described the use of high frequency jet ventilation. The dual challenge of safe induction and analgesia for thoracotomy was managed by placing thoracic epidural catheter via the caudal insertion site and retaining spontaneous ventilation until thoracotomy by Raghavendra et al [16] Phillipos and colleagues [17] have managed a three kg neonate in severe respiratory distress who had CLE of the left upper lobe.…”

Section: Discussionmentioning

confidence: 99%

Congenital lobar emphysema: Pitfalls and management

et al. 2010

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Congenital lobar emphysema is a rare entity presenting in the first month of life. It appears with varying degrees of respiratory distress, clinical and radiological evidence of over-aeration of the upper and middle lobes, mediastinal shift and hypoxia. Its early recognition and surgical intervention can be life-saving. Even today, despite advanced diagnostic techniques, pitfalls in diagnosis and management are not uncommon and the condition may be mistaken for pneumothorax or pneumonia. This report elucidates the anesthetic management of three such cases with a review of literature.

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High-Frequency Jet Ventilation for Resection of Congenital Lobar Emphysema

Cited by 32 publications

References 0 publications

Congenital lobar emphysema: diagnostic and therapeutic challenges

Congenital lobar emphysema: diagnostic and therapeutic challenges

Congenital lobar emphysema: 30-year case series in two university hospitals

Congenital lobar emphysema: Pitfalls and management

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