Bronchial diameters in children--use of the Fogarty catheter for lung isolation in children.
The right and left main bronchial diameters of 250 children were measured using computed tomography of the thorax. In 75% of the cases, the right main bronchial diameter was significantly larger than the left (95% CI 0.7-0.9, P<0.01). Age but not weight of a child is a good predictor of the bronchial diameter (Beta value is 2.81x10(-2) and 2.58x10(-2) for right and left main bronchial diameter respectively). A size 3 Fogarty catheter will provide effective bronchial blocking for children up to 4 years old. A size 5 Fogarty catheter can be used for most children from 5 to 12 years old. Larger Fogarty catheters or double-lumen tubes can be used in older children. Overinflation of the cuff should be avoided by fibreoptic bronchoscopy of the balloon. Our clinical application of the technique is discussed.
Tan
G M
GM
Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore.
Tan-Kendrick
A P A
AP
D000293:Adolescent; D000367:Age Factors; D001980:Bronchi / Q000033:anatomy & histology*; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008171:Lung Diseases / Q000601:surgery*; D008297:Male; D011237:Predictive Value of Tests; D011336:Probability; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013906:Thoracoscopy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods