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Rigid Bronchoscopic Placement of Fogarty Catheter as a Bronchial Blocker for One Lung Isolation and Ventilation in Infants and Children Undergoing Thoracic Surgery: A Single Institution Experience of 27 Cases

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Abstract

One-lung ventilation (OLV) is a challenging task in infants and children as few techniques are possible because of narrow anatomy. The aim of this study is to evaluate and experience lung isolation with Fogarty catheters as a bronchial blocker placed by rigid bronchoscope for OLV in infants and children with lung pathologies requiring surgical management in an industrial hospital. This study is a prospective study carried out in J.L.N. Hospital and Research Centre, Bhilai (CG), from January 2011 to December 2014. The study was designed to place Fogarty catheter for achieving OLV using rigid bronchoscope in children. The patient and anaesthesia characteristics, placement and positioning of Fogarty catheters, intraoperative course, complications and recovery of the patient were studied. The data were then compared with the relevant and available literature. Over the study period of 4 years, 27 cases were included, out of which 22 (81.48 %) cases had suppurative lung disease, three cases (11.11 %) had hydatid cyst of the lung, whereas one case (3.7 %) each of congenital lobar emphysema and congenital cystic adenomatoid malformation of the lung, respectively. In all cases general anaesthesia was provided using single lumen endotracheal tube and one lung ventilation achieved by parallel placement of Fogarty catheter as a bronchial blocker with rigid bronchoscope. The surgical management included thoracotomy with decortication in 21 cases, thoracotomy with excision of hydatid cyst in 3 cases, video-assisted thoracoscopic surgery, thoracotomy with left upper lobectomy and thoracotomy with left lower lobectomy in one case each, respectively. There were no major intraoperative and postoperative complications. There was no mortality in our study. We conclude that rigid bronchoscope can be safely and effectively used to place Fogarty catheter in main bronchus in infants and children for achieving OLV.

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Funding

This study was not funded by any Source/Firm/agency.

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Authors and Affiliations

  1. Department of Anaesthesia, J.L.N. Hospital and Research Centre, Bhilai, CG, India

    Sunil Kant Kamra

  2. Department of ENT and Head Neck Surgery, J.L.N. Hospital and Research Centre, Sector 9, Bhilai, Dist. Durg, CG, 490009, India

    Ashwin Ashok Jaiswal & Amrish Kumar Garg

  3. Department of Paediatric Surgery, J.L.N. Hospital and Research Centre, Bhilai, CG, India

    Manoj Kumar Mohanty

Authors
  1. Sunil Kant Kamra
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  2. Ashwin Ashok Jaiswal
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  3. Amrish Kumar Garg
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  4. Manoj Kumar Mohanty
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Correspondence to Ashwin Ashok Jaiswal.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from parents of all individual participants included in the study. Additional informed consent was obtained from parents of all individual participants for whom identifying information is included in this article.

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Kamra, S.K., Jaiswal, A.A., Garg, A.K. et al. Rigid Bronchoscopic Placement of Fogarty Catheter as a Bronchial Blocker for One Lung Isolation and Ventilation in Infants and Children Undergoing Thoracic Surgery: A Single Institution Experience of 27 Cases. Indian J Otolaryngol Head Neck Surg 69, 159–171 (2017). https://doi.org/10.1007/s12070-016-1026-9

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