Experience with the Arndt paediatric bronchial blocker

Abstract

Previously reported techniques for single lung ventilation in children have failed to provide consistent, single lung ventilation with relative ease and reliability. We report our experience with the use of a new device, the Arndt 5 French (Fr) paediatric endobronchial blocker, for single lung ventilation in a series of 24 children. We were able to achieve single lung ventilation in 23 of the 24 patients (aged 2-16 yr). Placement required approximately 5-15 min. Attempts at placement were aborted in one patient who was unable to tolerate even short periods of apnoea because of lung pathology. Although it has some limitations, our experience suggests that the paediatric bronchial blocker can be used as a consistent, safe method of single lung ventilation in most young children.

Extraluminal use of the Arndt pediatric endobron-chial blocker in an infant: a case report

“…The most commonly used method for achieving lung isolation in the infant is endobronchial intubation with a standard endotracheal tube in the contralateral mainstem bronchus or insertion of a Fogarty catheter as an endobronchial blocker in the ipsilateral mainstem bronchus. 4 The Arndt pediatric endobronchial blocker (5 Fr) has recently been introduced as a device for achieving lung isolation in the pediatric patient aged two to 16 yr. 5 Because the smallest lumen through which the pediatric endobronchial blocker can be inserted is an endotracheal tube with a 4.5-mm internal diameter, it cannot be placed from within an endotracheal tube of a size appropriate for infants the size of our patient. However, as we have described herein, the pediatric endobronchial blocker can be effectively utilized in a small infant when attached to the outside of an appropriately sized endotracheal tube and positioned with the assistance of a fibrescope.…”

“…The Fogarty catheter, not designed for use in the airway, has a high-pressure, low-volume balloon, and carries a theoretically greater risk for damage or rupture of the airway. 4,5 One last advantage of the endobronchial blocker over a Fogarty catheter is its central lumen, which provides a port for either ventilation or suction of the ipsilateral lung field.…”

Does the Future Belong to Bronchial Blockers?

“…Küçük çocuklarda klasik TLT ile endobronşiyal entübasyon yapılarak akciğer izolasyonu sağlanabilirse de, hipoventilasyon, hipoksi, sağlam akciğerin kontaminasyonu gibi komplikasyonları olabilir (45) . BB'ler son yıllarda çocuk hasta grubunda başarıyla kullanılmaktadırlar [46][47][48] . 4.5 mm TLT içinden 5F Arndt BB yerleştirilmesi gerektiğinde, dış çapı 2.0 mm veya daha küçük olan FOB kullanılmalıdır.…”

Severe desaturation while attempting one-lung ventilation for congenital cystic adenomatoid malformation with respiratory distress syndrome in neonate -A case report-

“…AEB, a type of bronchial blocker, is widely used in neonates and infants as well as adults for having advantageous properties such as a high-volume, low-pressure balloon and a multiport airway adapter [4-6]. …”