ed with a greater prevalence of airway complications compared to use of a bronchial blocker. METHODS: The Multicenter Perioperative Outcomes Group database was queried from 2004 to 2022 for one-lung ventilation cases in children, 2 months to 3 years of age, inclusive. Airway notes and free-text comments were manually reviewed for airway complications. Documented airway complications were considered the primary outcome and were divided into “Moderate” and “Critical.” Moderate airway complications were bronchial blocker or endotracheal tube movement leading to loss of isolation, hypoxemia requiring ventilatory intervention, bronchial blocker migration into the trachea, significant impairment of ventilation, and other. Critical complications included reintubation or airway replacement intraoperatively, complete endotracheal tube occlusion, cardiac arrest or airway-related bradycardia, and procedure aborted due to an airway issue. An adjusted propensity score-matched analysis was then used to assess the impact of a bronchial blocker on the outcomes of moderate and critical complications RESULTS: After exclusions, 704 patients were included in the primary analysis. In unadjusted analyses, no statistically significant difference was observed in moderate airway complications between endobronchial intubation and bronchial blocker cohorts: 37 of 444 (8.3%; 95% confidence interval [CI], 5.9%–11.3%) vs 28 of 260 (10.8%; 95% CI, 7.3%–15.2%) with P = .281. In the unadjusted analysis, the prevalence of critical airway complications was significantly higher in the endobronchial intubation cohort compared to the bronchial blocker cohort: 28 of 444 (6.3%; 95% CI, 4.2%–9.0%) vs 5 of 260 (1.9%; 95% CI, 0.6%–4.4%) with P = .008. In the propensity-matched cohort analysis, endobronchial intubation was associated with a slightly increased risk of critical complications compared to use of a bronchial blocker: 14 of 243 (5.8%; 95% CI, 2.8%–8.7%) vs 5 of 243 (2.1%; 95% CI, 0.3%–3.8%) with P = .035. CONCLUSIONS: Endobronchial intubation might be associated with a slightly increased risk of critical airway complications compared to use of a bronchial blocker in young children undergoing thoracic surgery and one-lung ventilation. Further, prospective studies are needed before a definitive change in practice is recommended....

中文翻译：

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接受单肺通气的幼儿支气管阻滞剂与支气管内插管：一项多中心回顾性队列研究


与使用支气管阻滞剂相比，ED 的气道并发症患病率更高。方法： 查询 2004 年至 2022 年多中心围手术期结果组数据库，查找 2 个月至 3 岁（含）儿童单肺通气病例。人工审查气道注释和自由文本评论是否存在气道并发症。记录的气道并发症被认为是主要结局，分为 “中度” 和 “危重”。中度气道并发症是支气管阻滞剂或气管插管运动导致隔离丧失、需要通气干预的低氧血症、支气管阻滞剂迁移到气管、通气严重受损等。严重并发症包括术中再插管或气道置换、气管插管完全闭塞、心脏骤停或气道相关性心动过缓，以及因气道问题而中止的手术。然后使用调整后的倾向评分匹配分析来评估支气管阻滞剂对中度和重度并发症结局的影响结果： 排除后，704 例患者被纳入初步分析。在未经调整的分析中，支气管插管和支气管阻滞剂队列之间的中度气道并发症没有观察到统计学上的显着差异：444 例中有 37 例（8.3%;95% 置信区间 [CI]，5.9%-11.3%）与 260 例中有 28 例（10.8%;95% CI，7.3%-15.2%），P = .281。在未经调整的分析中，与支气管阻滞剂队列相比，支气管内插管队列中严重气道并发症的患病率显著更高：444 例中有 28 例（6.3%;95% CI，4.2%-9.0%）与 260 例中有 5 例（1.9%;95% CI，0.6%-4.4%），P = .008。 在倾向匹配的队列分析中，与使用支气管阻滞剂相比，支气管内插管与严重并发症的风险略有增加相关：243 例中有 14 例（5.8%;95% CI，2.8%-8.7%）与 243 例中有 5 例（2.1%;95% CI，0.3%-3.8%），P = .035。结论： 在接受胸外科和单肺通气的幼儿中，与使用支气管阻滞剂相比，支气管内插管可能与严重气道并发症的风险略有增加有关。此外，在建议明确改变实践之前，需要进行前瞻性研究。