Lung Isolation in Infants Children

Lung Isolation in Infants Children

  • When lung isolation is required for infants, we often intentionally mainstem single lumen endotracheal tubes. In older infants and toddlers, bronchial blockers can be used.
  • We have 2 pediatric fiberscopes to guide and confirm endotracheal tube (ETT) placement: a noodle scope, which fits into ETTs > 2.5 mm, and a 2.8 mm bronchoscope, which fits into ETTs >3.5 mm.
  • Below is a table to estimate age-appropriate methods of single-lung ventilation (BB=bronchial blocker; DLT=double lumen tube; ID=internal diameter, where measurements=mm). If cuffed ETTs are selected in patients less than 8 years old, size should be decreased by 0.5 mm.

 

Age (yr) ETT (ID) BB (Fr) Univent DLT (Fr)
0.5-1 3.5-4.0 2    
1-2 4.0-4.5 3    
2-4 4.5-5.0 5    
4-6 5.0-5.5 5    
6-8 5.5-6.0 5 3.5  
8-10 6.0 cuffed 5 3.5 26
10-12 6.5 cuffed 5 4.5 26-28
12-14 6.5-7.0 cuffed 5 4.5 32
14-16 7.0 cuffed 5, 7 6.0 35
16-18 7.0-7.5 cuffed 7, 9 7.0 35, 37

Adapted from: Hammer GB, Fitzmaurice BG, Brodsky JB: Methods for single lung ventilation in pediatric patients. Anesth Analg 89:1426-1429, 199

 
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This information is meant to serve as an educational resource. Clinicians should use their own professional judgment in the care of any individual patient as the guidance contained in this document may not be appropriate for all patients or all situations.