Routine Extraluminal Use of the 5F Arndt Endobronchial Blocker for One-Lung Ventilation in Children up to 24 Months of Age

THORACIC SURGERY in neonates, infants, and small children increasingly is performed with minimally invasive techniques including thoracoscopy.1 One-lung ventilation (OLV) optimizes exposure during thoracoscopic surgery.1 The ediatric size 5F Arndt Endobronchial Blocker (AEB) (Cook edical Inc, Bloomington, IN) has been used successfully for ung isolation in children. A removable loop protruding through ts central lumen is used to guide it with a fiberoptic bronchocope (FOB) into the mainstem bronchus. Because a 4.5-mm nner-diameter (ID) endotracheal tube (ETT) or larger is reuired to accommodate the blocker concomitant with a peditric FOB for blocker placement, its endoluminal use is limited o children 2 years and older.2 The authors performed a retrospective review of their practice of placing the blocker outside the ETT (extraluminal) and to position the blocker with guidance by a bronchoscope inserted through the ETT (endoluminal) in children up to 24 months of age.