Extraluminal use of the Arndt pediatric endobron-chial blocker in an infant: a case report

Abstract

Purpose: Attaining lung isolation in the infant undergoing thoracic anesthesia can be challenging for the anesthesiologist. We describe a novel approach to performing lung isolation in an infant undergoing thoracotomy for lobectomy using an Arndt pediatric endobronchial blocker via an extraluminal technique.Clinical features: Lung isolation in an infant was achieved through the use of an Arndt pediatric endobronchial blocker placed externally to an endotracheal tube. The blocker's placement was facilitated through the use of a pediatric fibreoptic brochoscope placed through the guidewire of the extraluminally placed bronchial blocker. Conclusion:This novel technique may provide an easier and more reliable method of attaining single lung ventilation in infants and small children.

Anesthetic management for lobectomy of a 2-month-old infant with bronchogenic cyst: Case report along with review of literature

“…This limitation can be managed with insertion of 5 Fr Arndt endobronchial blocker through an extraluminal technique rather than its intraluminal conventional placement. [5]…”

Does the Future Belong to Bronchial Blockers?

“…Küçük çocuklarda klasik TLT ile endobronşiyal entübasyon yapılarak akciğer izolasyonu sağlanabilirse de, hipoventilasyon, hipoksi, sağlam akciğerin kontaminasyonu gibi komplikasyonları olabilir (45) . BB'ler son yıllarda çocuk hasta grubunda başarıyla kullanılmaktadırlar [46][47][48] . 4.5 mm TLT içinden 5F Arndt BB yerleştirilmesi gerektiğinde, dış çapı 2.0 mm veya daha küçük olan FOB kullanılmalıdır.…”

“…4.5 mm TLT içinden 5F Arndt BB yerleştirilmesi gerektiğinde, dış çapı 2.0 mm veya daha küçük olan FOB kullanılmalıdır. 4.5 mm'den daha küçük TLT ile entübe edilmesi gereken hastalarda, uygun boyuttta FOB yoksa BB ya tüp dışarısından ilerletilir ya da floroskopiyle yerleştirilir [47,48] .…”

Airway management techniques for one lung ventilation in children - what else!

“…[1] With the advancement of technology, the thoracoscopic procedures in children are increasingly being performed in all age groups. This requires a deflated and silent lung to provide an “adequate working space in a relatively small anatomic compartment.”[1] This journal published a review article where in authors have discussed the OLV strategies in children undergoing video assisted thoracoscopic surgery. [2] Though the authors have described the various techniques but these may be applicable to larger children only.…”

“…[34] The smallest Arndt paediatric endobronchial blocker is 5 Fr and may be suitable for children more than 2 years as it requires at least a 4.5-mm internal diameter endotracheal tube. [134]…”