Radiological incidence of unilateral pulmonary edema after minimally invasive cardiac surgery

Khalil, Nadeen Habib; Anders, Rebecca; Forner, Anna Flo; Gutberlet, Mathias; Ender, Joerg

doi:10.1053/j.jvca.2018.08.111

Cited by 1 publication

(12 citation statements)

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“…Total anesthesia time was defined as the time between monitoring of the patient and exiting from the operating room. Specifically, unilateral pulmonary edema was diagnosed by intensivists and radiologists' together as newly occurring pulmonary edema on chest radiography and computed tomography 15‐17 . Clinical and blood gas changes were evaluated.…”

Section: Methodsmentioning

confidence: 99%

“…It has been reported that the incidence of bronchial injuries dropped from 23.8% in the DL endotracheal intubation group to 10.3% in the SL intubation group 23 . In addition, lung isolation may lead to atelectasis, pneumonia, and unilateral lung edema 15‐19 …”

Section: Commentsmentioning

confidence: 99%

“…Currently, DL endotracheal intubation with lung isolation is the standard for robotic cardiac surgery in high volume robotic cardiac centers 1‐3,10,11,15‐19 . This approach has been applied in video‐assisted cardiothoracic surgery to ensure lung exclusion 20‐26 .…”

Section: Commentsmentioning

confidence: 99%

“…In these circumstances, multiple intubation attempts may lead to tracheobronchial injury, bleeding, hypoxemia, and bronchospasm 12‐14 . Moreover, fatal pulmonary events such as unilateral lung edema may be a catastrophe and increase the length of hospital stay and cost 15‐19 …”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, right‐sided unilateral pulmonary edema developed in several patients. With the goal of providing better outcomes, the studies and alternative techniques in minimally invasive cardiac surgery were reviewed 1‐26 . The literature on robotic cardiac surgery presented no recommendations about the use of SL endotracheal tubes without lung isolation.…”

Section: Introductionmentioning

confidence: 99%

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Robotic‐assisted cardiac surgery without lung isolation utilizing single‐lumen endotracheal tube intubation

et al. 2020

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Objectives This study assessed the feasibility and outcomes of performing robotic cardiac surgery without lung isolation using single‐lumen (SL) endotracheal tube intubation. Methods Between 2013 and 2017, 132 patients underwent robotically‐assisted atrial septal defect closure. A retrospective analysis was performed of 23 patients (11 males, mean age 30.9 ± 5 years) who underwent robotic surgery with double‐lumen (DL) endotracheal tube intubation (group 1) compared with 109 patients (57 males, mean age 32.4 ± 7.5 years) undergoing the same procedure with SL endotracheal intubation (group 2). The patient groups were compared in terms of demographic characteristics, operative data, and complications. The technical feasibility of the robotic procedure without lung isolation was evaluated. Results There were no mortality, intraoperative complication, and conversion. Mean total anesthesia time was significantly decreased in the SL intubation group (238.3 ± 22.4 vs 227.2 ± 21.2 minutes; P = .025). First‐pass intubation success was significantly higher in the SL intubation group (17 [73.9%] vs 98 [89.9%] patients; P = .032). Mean ventilation time (10.9 ± 5.3 hours), intensive care unit stay (16.8 ± 10.1 hours), and the length of hospital stay (3.8 ± 1.2 days) was significantly decreased in patients with SL tube (P < .05). Unilateral reexpansion pulmonary edema was observed in five (21.7%) patients with DL tube, whereas no patient with SL tube had this complication. Conclusions SL endotracheal tube intubation without lung isolation is a feasible and safe airway alternative in robotic cardiac procedures. This approach resulted in shorter anesthesia time, ventilation time and the length of hospital stay. Port placement and robotic set‐up can be uneventfully performed without lung isolation.

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Section: Methodsmentioning

confidence: 99%

Section: Commentsmentioning

confidence: 99%