• Jinxi Huang, Hua Cao, Qiang Chen, Chaoming Zhou, Zengchun Wang, Dianming Wu, Junjie Hong, and Songming Hong.
• Department of Cardiothoracic Surgery, Fujian Provincial Maternity and Children's Hospital, Fuzhou City, China.
• J. Cardiothorac. Vasc. Anesth. 2021 Aug 1; 35 (8): 2326-2329.

ObjectiveTo compare the difference between single-lung ventilation with bronchial occlusion and double-lung ventilation with carbon dioxide artificial pneumothorax for thoracoscopic lobectomy in infants.DesignThis was a retrospective study.SettingIt was done in a teaching hospital.ParticipantsBetween March 2017 and April 2020, a total of 72 infants underwent thoracoscopic lobectomy in the authors' hospital.InterventionsTwenty-one patients received single-lung ventilation with bronchial occlusion, and 51 patients received carbon dioxide (CO2) artificial pneumothorax.MeasurementsThe patient data included the endotracheal tube length, surgical exposure, intraoperative blood loss, and surgery duration. The mean arterial pressure (MAP), central venous pressure (CVP) and peak inspiratory pressure (Ppeak), partial pressure of oxygen in arterial blood (PaO2), and partial pressure of carbon dioxide in arterial blood (PaCO2) were measured at four points: time of bilateral lung ventilation before the thoracic surgery (T0), 10 minutes after the surgery started (T1), 30 minutes after the surgery started (T2), 60 minutes after the surgery started (T3), and 10 minutes after the surgery was over (T4).Main ResultsCompared to artificial pneumothorax, the bronchial occlusion group has the following advantages: the surgical exposure was better, the surgery duration was shorter, there was less intraoperative bleeding, and the duration of tracheal intubation was shorter (p < 0.05); bronchial occlusion resulted in a lower MAP but a higher CVP in infants at T1, T2, and T3 (p < 0.05) than the artificial pneumothorax group and resulted in a lower PaCO2 and higher PaO2 at T2, T3, and T4 (p < 0.05). There was no significant difference in Ppeak between the two groups (p > 0.05).ConclusionCompared with CO2 artificial pneumothorax, bronchial occlusion is more favorable for thoracoscopic lobectomy in infants.Copyright © 2020 Elsevier Inc. All rights reserved.

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