Lung isolation using retrograde intrabronchial Fogarty catheter: Experience from 35 cases

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Critical Care Medicine

Background:

• One-lung ventilation is crucial for thoracic surgery, but standard methods are equipment-intensive.
• Emergencies, pediatric cases, and low-resource settings often lack specialized equipment for lung isolation.

Purpose of the Study:

• To evaluate the efficacy and safety of retrograde Fogarty catheter insertion for one-lung ventilation.
• To present a case series demonstrating this alternative technique in diverse thoracic surgical scenarios.

Main Methods:

• A case series of 35 patients undergoing thoracic surgery between 1984 and 2000.
• Lung isolation was achieved via retrograde intraoperative insertion of a Fogarty catheter into the bronchus.
• Indications included pulmonary hydatid cysts, thoracic trauma, and bronchopleural fistulae.

Main Results:

• Successful one-lung ventilation was achieved in all 35 patients.
• No technique-related complications or adverse events from catheter placement were reported.
• Stable oxygenation and ventilation facilitated safe surgical management.

Conclusions:

• Retrograde Fogarty catheter insertion is a simple, safe, and cost-effective method for lung isolation.
• This technique is particularly valuable in emergencies, pediatric surgery, and resource-limited environments.
• This study represents the first case series and second report on this alternative approach.