Background This study aimed to evaluate the impact and safety of extraluminal bronchial blockers on ventilation parameters in pediatric patients undergoing one lung ventilation (OLV) for thoracoscopic surgery. We hypothesized that, compared with endotracheal tube ventilation alone, the use of a bronchial blocker positioned outside the endotracheal tube can enhance lung collapse quality and improve ventilation efficiency without increasing the risk of complications. Methods In this prospective randomized controlled trial, a total of 128 pediatric patients who underwent OLV thoracoscopic surgery between February 2021 and February 2024 were enrolled and randomly assigned to two groups using a random number table method. The control group (n = 64) received ventilation via endotracheal tubes alone, while the study group (n = 64) received ventilation using extraluminal bronchial blockers. The primary outcome measures were the rate of satisfactory lung collapse. Secondary outcomes included arterial carbon dioxide pressure 20 min after OLV, surgical duration, intubation time, catheter dislodgement rate, and postoperative complications. Results The rate of excellent and good lung collapse was 100% in the study group, significantly higher than the 90.62% observed in the control group (p < 0.05). Airway pressure and partial pressure of carbon dioxide at 20, 40, and 60 min post-OLV were lower in the study group than in the control group, with significant between-group effects (η²ₚ = 0.54 and 0.24, respectively; p < 0.05). The study group demonstrated significantly shorter surgical duration and intubation times compared to the control group (p < 0.05), with mean differences of – 21.34 min [95% confidence interval (CI): – 32.68, -9.99] and − 1.17 min (95% CI – 1.41, – 0.93), respectively. The incidence of endotracheal tube displacement was lower in the study group (4.69%) than in the control group (17.19%), with a relative risk of 0.27 (95% CI 0.08, 0.92) (p < 0.05). No significant differences were detected between the groups in the incidence of postoperative sore throat, hoarseness, hypoxemia, or nausea and vomiting (p > 0.05). Conclusion The use of an extraluminal bronchial blocker with an endotracheal tube allowed for improved lung collapse quality and more effective maintenance of ventilation efficiency during OLV in pediatric thoracoscopic surgery, while demonstrating a favorable safety profile.

The efficacy and safety of extraluminal bronchial blockers in pediatric patients during one-lung ventilation for thoracoscopic surgery

期刊论文
发表日期：

2026年5月4日

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Ke Wu,
Yong-Sheng Qiu,
Zheng-Chen Li,
Yuan Wang

摘要

Background

This study aimed to evaluate the impact and safety of extraluminal bronchial blockers on ventilation parameters in pediatric patients undergoing one lung ventilation (OLV) for thoracoscopic surgery. We hypothesized that, compared with endotracheal tube ventilation alone, the use of a bronchial blocker positioned outside the endotracheal tube can enhance lung collapse quality and improve ventilation efficiency without increasing the risk of complications.

Methods

In this prospective randomized controlled trial, a total of 128 pediatric patients who underwent OLV thoracoscopic surgery between February 2021 and February 2024 were enrolled and randomly assigned to two groups using a random number table method. The control group (n = 64) received ventilation via endotracheal tubes alone, while the study group (n = 64) received ventilation using extraluminal bronchial blockers. The primary outcome measures were the rate of satisfactory lung collapse. Secondary outcomes included arterial carbon dioxide pressure 20 min after OLV, surgical duration, intubation time, catheter dislodgement rate, and postoperative complications.

Results

The rate of excellent and good lung collapse was 100% in the study group, significantly higher than the 90.62% observed in the control group (p < 0.05). Airway pressure and partial pressure of carbon dioxide at 20, 40, and 60 min post-OLV were lower in the study group than in the control group, with significant between-group effects (η²ₚ = 0.54 and 0.24, respectively; p < 0.05). The study group demonstrated significantly shorter surgical duration and intubation times compared to the control group (p < 0.05), with mean differences of – 21.34 min [95% confidence interval (CI): – 32.68, -9.99] and − 1.17 min (95% CI – 1.41, – 0.93), respectively. The incidence of endotracheal tube displacement was lower in the study group (4.69%) than in the control group (17.19%), with a relative risk of 0.27 (95% CI 0.08, 0.92) (p < 0.05). No significant differences were detected between the groups in the incidence of postoperative sore throat, hoarseness, hypoxemia, or nausea and vomiting (p > 0.05).

Conclusion

The use of an extraluminal bronchial blocker with an endotracheal tube allowed for improved lung collapse quality and more effective maintenance of ventilation efficiency during OLV in pediatric thoracoscopic surgery, while demonstrating a favorable safety profile.