Techniques of One-Lung Ventilation (Lung Isolation) in Children (Technical Note)

Srinivasan Ramachandran [1] , Savitri Velayudhan [2]

[1] Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India.

[2] Department of Anesthesiology, Indira Gandhi Medical College and Research Institute, Puducherry 605006, India

Keywords

Anesthesia technique

Lung isolation technique

One-lung ventilation

Bronchial intubation

Thoracic surgery

Abbreviations

CPAP - Continuous positive airway pressure

DLT - Double lumen tube

ETT - Endotracheal tube

FOB - Fiberoptic broncho scope

OLV - One-lung ventilation

V/Q - ventilation-perfusion

Abstract

One-lung ventilation (OLV) in pediatric patients, especially those under 8 years of age, poses significant challenges due to anatomical constraints. However, the need for lung isolation is increasing with advancements in surgical techniques such as thracoscopy. The availability of newer bronchial blockers and innovative methods of their placement have made OLV more feasible. This article briefly reviews the recent developments in pediatric OLV. Technique such as double lumen tube, bronchial blockers and endobronchial intubation of single lumen tube are discussed. Technical tips of using Bronchial blockers such as Fogarty catheters, Arndt blocker, uniblocker and univent tube are described.