Curious Case of Pediatric One-Lung Ventilation with Two Endotracheal Tubes: A Case Report

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Respiratory Care

Background:

• One-lung ventilation (OLV) is crucial for thoracic surgery, enabling surgical site visualization.
• Standard OLV methods include bronchial blockers, double-lumen tubes, and specialized pediatric tubes.
• Accurate placement of these devices typically requires a fiberoptic bronchoscope.

Observation:

• A 6-year-old child required left lower lobe lobectomy, necessitating one-lung ventilation.
• The procedure was performed in a setting with limited resources, specifically lacking a pediatric-sized fiberoptic bronchoscope.
• Alternative methods for device placement and confirmation were explored.

Findings:

• The study successfully implemented one-lung ventilation using two single-lumen endotracheal tubes.
• Placement was guided by a C-MAC video laryngoscope, circumventing the need for a fiberoptic bronchoscope.
• This technique ensured adequate ventilation and surgical exposure during the lobectomy.

Implications:

• This approach offers a viable alternative for pediatric one-lung ventilation in resource-limited environments.
• It highlights the utility of video laryngoscopy in managing airway devices for OLV.
• The findings may guide anesthetic management for pediatric thoracic surgery where specialized equipment is unavailable.