Forgarty Catheter for Lung Isolation and One-lung Ventilation in Infants with Multiloculated Empyema with Bronchopleural Fistula Undergoing Exploratory Thoracotomy: an Alternative of Double Lumen Tube
Baginda Aflah (a*), Iwan Abdul Rachman (b), Suwarman (b)

a) Department of Anesthesiology and Intensive Therapy
b) Faculty of Medicine, Padjadjaran University

Abstract

Abstract Lung isolation and one-lung ventilation are generally facilitated by the use of a Double Lumen Catheter (DLT) to achieve a good operating field, prevent contamination, maintain adequate ventilation and oxygenation. In the infant and pediatric population, it becomes a problem because there is no suitable size of DLT on the market. In this article, we report a 2.5-month old infant with multiloculated empyema with bronchopleural fistula in the right lung who underwent a thoracotomy for decortication and closure of the fistula. In this case, we used the Forgarty Catheter, commonly used in vascular surgery for thrombectomy, as an alternative to DLT. We made this Forgarty Catheter a bronchial blocker to isolate the patient^s right lung, we inserted it into a modified endotracheal tube (ETT) with a Y connector. Intraoperatively, the Forgarty catheter can properly act as a bronchial blocker to prevent contamination of healthy lungs, to facilitate one-lung ventilation and oxygenation can be provided adequately. Postoperatively the Forgarty catheter was removed and both of the patient^s lungs were re-expanded and the patient was transferred to the PICU for further observation. In conclusion, Forgarty Catheter can be an alternative to DLT in infants and pediatrics undergoing thoracic surgery.

Keywords: Forgarty Catheter, lung isolation, One lung ventilation, Thoracic surgery, Pediatric, Empyema, Bronchopleural fistula.

Topic: Clinical Practice