Use of Fogarty embolectomy catheter for one lung ventilation during thoracic surgery in children: A prospective study

Abstract

Introduction
One lung ventilation (OLV) in pediatric patients is challenging. Fogarty Catheter can be used as a mechanical bronchial blocker to achieve OLV.

Methods
Ten pediatric patients undergoing lung isolation for thoracic surgery with Fogarty embolectomy catheter were prospectively studied. Catheter was inserted either through the endotracheal tube (ETT) or by the side of ETT. Proper positioning was done under C-arm fluoroscopy guidance and lung isolation confirmed with auscultation of chest.

Results
Eighty percent of patients underwent right lung isolation. Half of the subjects had Fogarty catheter placed through the ETT and remaining half had the catheter placed by the side of the tube. Number of attempts required for lung isolation was 1 to 4 and time required for proper catheter placement was 5 to 18 minutes. There were 4 episodes of desaturation in three patients which were successfully managed. Quality of lung isolation was good to excellent as per the feedback of operating surgeon. Number of attempts and time consumed for proper catheter placement were similar in both techniques. Number of attempts was more and time required for lung isolation was longer for isolation of left lung. Similarly, in patients who desaturated during the procedure, number of attempts were more and time consumed for lung isolation was longer.

Conclusions
Fogarty embolectomy catheter can be considered for lung isolation in pediatric patients. Both -through and by the side of endotracheal tube techniques of catheter insertion were similar in terms of time required fo