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Related Concept Videos

Endotracheal Intubation I: Procedure01:15

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Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Updated: Mar 16, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
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Selective lung intubation during paediatric thoracic surgeries.

V Mixa, B Nedomova, M Rygl

    Bratislavske Lekarske Listy
    |August 23, 2016
    PubMed
    Summary

    Selective lung intubation using Univent or double-lumen tubes (DLT) in children undergoing thoracic surgery presents challenges. While improving surgical conditions, these methods have associated complications requiring careful consideration.

    Keywords:
    Univent tubedouble-lumen tube.paediatric anaesthesiapaediatric thoracic surgeryselective lung intubation

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    Area of Science:

    • Pediatric Anesthesiology
    • Thoracic Surgery
    • Respiratory Management

    Background:

    • Selective lung intubation is crucial for pediatric thoracotomy and thoracoscopy.
    • Current practices utilize Univent tubes for younger children and double-lumen tubes (DLT) for older children.
    • Alternative methods involve regular endotracheal intubation with surgical retraction.

    Purpose of the Study:

    • To analyze the outcomes and complications of selective intubation methods in pediatric thoracic surgery.
    • To evaluate the effectiveness of Univent tubes and DLT in pediatric patients.
    • To assess the impact of selective intubation on surgical conditions.

    Main Methods:

    • Retrospective analysis of 860 thoracic surgeries.
    • Focus on 491 cases involving selective intubation (Univent and DLT).
    • Documentation of device-specific complications and insertion failures.

    Main Results:

    • Univent tube complications: obturating balloon dislocation (29.8%) and perforation (5.2%).
    • DLT insertion challenges: failure to fit (20.6% required reinsertion) and inability to insert (1.8%).
    • Standard use of selective intubation in children over two years improved surgical conditions.

    Conclusions:

    • Both Univent tubes and DLT are associated with significant intraoperative complications in pediatric patients.
    • Despite complications, selective intubation methods, particularly in older children, enhance surgical intervention conditions.
    • Further research may be needed to optimize device selection and minimize adverse events in pediatric thoracic surgery.