Use of embolectomy catheter for lung isolation in pediatric patients undergoing lung decortication surgery: experience of ten cases

Abstract

Abstract Background Pediatric one lung ventilation is challenging to achieve; smaller the child greater is the challenge. Challenge gets bigger due to unavailability of proper sized lung isolation devices. The aim of this case series was to assess the feasibility of using embolectomy catheter for lung isolation in 10 children who were planned to undergo lung decortication surgery. Results Age wise predictions of airway diameters were used to select sizes of endotracheal tube and embolectomy catheter. We used a Fogarty catheter, with its tip bent to 30° and placed parallel to a cuffed endotracheal tube, under fiberoptic bronchoscope guidance to achieve lung isolation. Desired lung was deflated passively after achieving lung isolation. Embolectomy catheter cuff position was reconfirmed with bronchoscopy after patient positioning. Ages of children ranged from 2 to 6 years. Four patients required right lung isolation while six required left lung isolation. Dislodgement of embolectomy catheter while positioning or during surgery did not occur in any case. Surgeons reported good to excellent lung isolation in all the cases. All cases were successfully extubated at the end of surgery. Conclusions Embolectomy catheter for one lung ventilation in pediatric cases maybe a useful alternative in absence of customized devices.

Keywords

• Bronchoscopy
• Child
• General anesthesia
• Intratracheal intubation
• One lung ventilation