Lung-protective ventilation in one-lung ventilation for children undergoing minimally invasive ventricular septal defect surgery: Effects on hemodynamic

Tóm tắt

A prospective cohort study was conducted on 63 pediatric patients with congenital VSD was conducted to describe hemodynamic changes and adverse effects of protective lung ventilation (PLV) during one-lung ventilation (OLV) in minimally invasive ventricular septal defect (VSD) surgery. 63 pediatric patients with congenital VSD were randomly assigned into two groups: conventional lung ventilation (CLV) and protective lung ventilation (PLV), from June 2023 to December 2024 at the Vietnam National Children’s Hospital. Data collected included patient characteristics, anatomical lesions, surgical details, mechanical ventilation parameters, hemodynamic and blood gas monitoring during and after surgery, ventilation duration, and respiratory complications. Comparison was made between heart rate, mean blood and central venous pressure at different timelines. Statistical methods included t-tests, Chi-square, regression analysis, using Jamovi 2.6.24 software. Children diagnosed with congenital VSD underwent minimally invasive open-heart surgery via right mini-thoracotomy. 29 received CLV, and 34 received PLV. Mean age: 26.6 ± 20.6 months old. Mean weight: 11 ± 4kg. Cardiopulmonary bypass time: 67.9 ± 15.3 mins. Aortic cross-clamp time: 46.2 ± 12.1 mins. 10 patients were extubated in the operating room Postoperative ventilation time: average 5.2 hours. No organ failure or major hemodynamic instability occured. Protective lung ventilation is safe during anesthesia and resuscitation for minimally invasive VSD repair in children, with no major circulatory or hemodynamic complication.