Methods for Single-Lung Ventilation in Pediatric Patients

Management of traumatic tracheobronchial separation in a teenager using a fabricated extra-long endotracheal tube

“…Previously-described techniques for single-lung ventilation in children include use of a double-lumen endotracheal tube, endotracheal tube with moveable blocker (Univent), selective endobronchial intubation and intrabronchial catheters surgically introduced through the chest [14]. Published guidelines for endobronchial intubation based on bronchus measurements dictate that our patient would have tolerated a 7.0 cuffed endotracheal tube in the left main bronchus [14]. However, our patient's left main bronchus was edematous and we therefore used a smaller tube to avoid further trauma.…”

Video-Assisted Thoracic Surgery Lobectomy for Extralobar Pulmonary Sequestration in a Child: Report of a Case

“…Mezzetti et al reported performing successful VATS lobectomy for intralobar sequestration of the right lower pulmonary lobe in an infant, by using a double-lumen endotracheal tube made from a smallcaliber Marrato's tube, 7 but they did not describe the device in detail. Hammer et al proposed some tube selection guidelines for single lung ventilation in children, 8 one of which involved the use of a balloon-tipped tronchial blocker with an endotracheal tube (ETT). They initially inserted an ETT into the operative bronchus, then advanced a guidewire through the ETT into that bronchus, removed the ETT, and advanced the blocker catheter along the guidewire into the bronchus.…”

“…Finally, the ETT was reinserted into the trachea alongside the blocker catheter. 8 However, the potential problem of this device, as described by Hammer et al, was dislodgement of the blocker balloon into the trachea. We modified their procedure with our original tracheal tube, using the hole of the catheter to aspirate air from the left lung, and using the balloon to occlude the left main bronchus.…”

“…8 This operation should not be very difficult for extralobar pulmonary sequestration, as the malformation is well separated from the normal lung tissue by its own pleural envelope. However, inflammatory changes resulting from previous infections may complicate the surgery by destroying the intersegmental plane.…”

The Role of Thoracoscopic Surgery in Pediatric Oncology

“…33,34 OLV methods in pediatric patients may be achieved with use of a double-lumen tube, uninvent tube, Arnt blocker, Fogarty catheter, and endobronchial intubation. [34][35][36][37] In an attempt to create this working space, anesthesiologists are challenged to perform OLV to allow for lung collapse on the operative side. In order to achieve OLV, airway anatomy of the patient with detailed knowledge of the trachea size and of the size and length of the main bronchus to be selectively intubated is required.…”