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Selective bronchial intubation with the UniventR tracheal tube in children

Publication at Second Faculty of Medicine |
2008

Abstract

Objective: Selective bronchial intubation is used to isolate and collapse the treated lung. As a rule, intubation is necessary in order to carry out thoracotomies and thoracoscopies.

In adults intubation is carried out using a double-lumen tube. In children whose narrow airways do not allow for the insertion of double- -lumen tubes, we have been using the Univent endotracheal tube with a movable obturator.

Design: Clinical, retrospective. Setting: Department of Anaesthesia and Intensive Care Medicine, University Hospital.

Materials and methods: A total of 188 patients aged 1.5 to 18 years were included in the study. The children were grouped according to the size of the Univent tube (Fuji System Corp., Tokyo, Japan) inserted.

We noted the diagnoses for which the patients were indicated for surgery, and we assessed the difficulties and complications during the insertion and intraoperative use of the Univent tube. Results: There were 4 (2.1%) difficult intubations on induction of anaesthesia; 33 cases (17.5%) of difficult insertion of the obturator; and a failure to introduce the obturator in 9 cases (4.8%).

Selective intubation of the lungs was unsuccessful in 14 cases (7.4%). The reasons for these complications are analysed in the text.

Conclusions: Selective intubation of the lungs with the 100% silicone Univent tube is an easy and gentle me - thod suitable for children aged two and up. It is a fully adequate alternative to the double-lumen tube normally used to secure the airway.