title: Printed three-dimensional airway model assists planning of single-lung ventilation in a small child.
abstract: BACKGROUND
  Single-lung ventilation in infants and small children is challenging because suitable sizes of double-lumen cuffed tracheal tubes are not available. A 6-yr-old child required pulmonary saline washout for primary alveolar proteinosis, and therefore needed sequential single-lung ventilation in order to achieve safe oxygenation. Before undertaking this potentially hazardous procedure, we practised bronchial intubation on an anatomical model of her airway constructed from computed tomography (CT) data.
  
  
  METHODS
  We created a full-scale, anatomically accurate, transparent plastic model of the trachea and main bronchi on a three-dimensional printer using data from a CT scan. We then performed several different airway approaches to identify those likely to be most suitable, ex vivo, before the clinical procedure was carried out on the patient.
  
  
  RESULTS
  The model helped us to choose the type and size of bronchial tubes and to practise their insertion beforehand. Subsequently, during anaesthesia, the chosen technique was successful.
  
  
  CONCLUSIONS
  Three-dimensional printing of a model of the airway of a small child aided planning of bronchial intubation and single-lung ventilation. Three-dimensional printing of airway structures may have wider application in anaesthesia practice.
authors.affiliation: Department of Anaesthesia, Institute of Child Health, University College London, London, UK carolineannewilson@gmail.com.
authors.forename: C A
authors.initials: CA
authors.lastname: Wilson
authors.affiliation: Department of Radiology, Institute of Child Health, University College London, London, UK Institute of Child Health, Institute of Child Health, University College London, London, UK.
authors.forename: O J
authors.initials: OJ
authors.lastname: Arthurs
authors.affiliation: Department of Anaesthesia, Institute of Child Health, University College London, London, UK Portex Department of Anaesthesia, Institute of Child Health, University College London, London, UK.
authors.forename: A E
authors.initials: AE
authors.lastname: Black
authors.affiliation: Institute of Cardiovascular Science, University College London, London, UK Cardiorespiratory Unit, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Schievano
authors.affiliation: Kings College Medical School, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Hunt
authors.affiliation: Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: van Hoog
authors.affiliation: Institute of Child Health, Institute of Child Health, University College London, London, UK Department of Respiratory Paediatrics, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N 3JH, UK.
authors.forename: C
authors.initials: C
authors.lastname: Wallis
authors.affiliation: Department of Anaesthesia, Institute of Child Health, University College London, London, UK Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: M R J
authors.initials: MR
authors.lastname: Sury
mesh_terms: D001980:Bronchi; D001995:Bronchography; D002648:Child; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008953:Models, Anatomic; D061810:One-Lung Ventilation / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000000981:diagnostic imaging*
keywords: airway management; models, anatomical; one-lung ventilation