A modified approach to intubation and single-lung ventilation for lobectomy in a 2-year-old child: a case report

The subject of this case report is a 2-year-old girl who was admitted to the operating room for treatment of recurrent parapneumonic empyema of the right lung. Because antibiotics and traditional therapies were not effective, surgical management was required. A single-lumen endotracheal tube was the chosen method for intubation. Once tube placement was confirmed and the patient's vital signs were acceptable, guidance of the endotracheal tube into the left mainstem Single-bronchus was initiated via fiberoptic bronchoscope. Advancement of the endotracheal tube was unsuccessful after 2 attempts because of poor visualization through the scope. Successful placement was achieved under fluoroscopy with the use of a C-arm. Current practice suggests that using fluoroscopy is a safe alternative for verifying tube placement in the pediatric population.