One lung ventilation in infants and children: Experience with Marraro double lumen tube

Abstract

Background: Our objective was to evaluate the efficacy of selective bronchial intubation and independent lung ventilation during thoracic surgery in children up to 3 years, using a double lumen tube. Methods: We studied retrospective (cases 1-6) and prospective cases (7-17) between January 1996 and December 2000 at the All India Institute of Medical Sciences, New Delhi, India and at Fatebenefratelli and Ophthalmiatric Hospital, Milan, Italy. Seventeen children, 1 day to 3 years of age and weighing 2.7-12 kg, were submitted to thoracic surgery for a variety of surgical conditions. Anesthesia was conducted as usual in this type of patient and selective intubation was performed using a double lumen tube (Marraro Pediatric double lumen tube). During the operation one lung ventilation was applied and at the end of surgery the collapsed lung was reexpanded independently from the contralateral lung. Results: Six children remained intubated with a double lumen tube for between 8 and 48 h and one (case no. 11) with a single lumen tube for 24 h, while 10 of the older children were extubated on the table. No serious complications during or after surgery were noted and after extubation all the children recovered completely without sequelae. Conclusions: The double lumen tube appears to be very effective in allowing one lung ventilation in this age group during thoracic surgery. © 2005 Blackwell Publishing Ltd.