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Updated: Oct 2, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Selective fiberoptic left main-stem intubation for severe unilateral barotrauma in a 24-week premature infant
Michael T Meyer1, Tom B Rice, John C Glaspey
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Abstract:
A 24-week premature infant developed severe right-sided pulmonary barotrauma secondary to mechanical ventilation for respiratory distress syndrome (RDS). High-frequency oscillatory ventilation and permissive hypercapnia were initiated. A chest tube was placed to relieve a pneumothorax, and a catheter was inserted into an air-filled cyst for drainage. These maneuvers failed to improve the child's respiratory status. The child's left main-stem bronchus was then successfully fiberoptically intubated for single-lung ventilation in order to reduce the unilateral barotrauma. Single-lung ventilation was effectively and safely continued for 5 days, with complete resolution of the pulmonary barotrauma.
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