An unusual way to use an endobronchial blocker.
The techniques for lung isolation in infants are, endobronchial intubation and bronchical blockade with Fogarty catheter or a univent tube. Unlike endobronchial intubation, bronchial blockade has the advantage that lung can be segregated at will. Endobronchial blocker is usually placed as a planned procedure just after induction of anaesthesia either under vision with the help of a fibreoptic bronchoscope or alternatively a rigid bronchoscope is used to position it in either bronchus and later the trachea. We report here a rather unusual and desperate way of using a Fogarty catheter halfway through the surgery due to unforeseen bleeding during thoracotomy. The pros and cons of attempting selective segregation and regional ventilation of lung under these circumstances is discussed.
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Department of Paediatric Anaesthesia, Rajkumar Society, Wadhavli Village Chembur, Mumbai, India. lakshmil@hotmail.com.