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Extraluminal use of the Arndt pediatric endobronchial blocker in an infant: a case report

[L’usage extracavitaire du bloqueur endobronchique pédiatrique Arndt chez un enfant : une présentation de cas]

John L. Bastien, MD^*, Joseph G. O’Brien, MD^* and Frazier W. Frantz, MD FACS

^* From the Department of Anesthesiology, and the
Division of Pediatric Surgery Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.

Address correspondence to: Dr. John L. Bastien, Department of Anesthesiology, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708-2197, USA. Phone: 757-953-3238; Fax: 757-953-0871; E-mail: jlbastien{at}msn.com

Purpose: Attaining lung isolation in the infant undergoing thoracic anesthesia can be challenging for the anesthesiologist. We describe a novel approach to performing lung isolation in an infant undergoing thoracotomy for lobectomy using an Arndt pediatric endobronchial blocker via an extraluminal technique.

Clinical features: Lung isolation in an infant was achieved through the use of an Arndt pediatric endobronchial blocker placed externally to an endotracheal tube. The blocker’s placement was facilitated through the use of a pediatric fibreoptic brochoscope placed through the guidewire of the extraluminally placed bronchial blocker.

Conclusion: This novel technique may provide an easier and more reliable method of attaining single lung ventilation in infants and small children.