One-Lung Ventilation in a Malnourished Child Using a Fogarty Catheter: A Practical Solution for Pediatric Airway Isolation

Abstract

Background: One-lung ventilation (OLV) in pediatric patients presents significant challenges because of the small airway diameter and limited availability of appropriately sized lung-isolation devices. These difficulties may be further exacerbated in malnourished children, who often have reduced physiological reserves and are more vulnerable to perioperative respiratory complications.

Case Presentation: We report the anesthetic management of a malnourished child requiring a surgical procedure necessitating OLV. Conventional double-lumen tubes and bronchial blockers were unsuitable because of the patient's small airway size. A Fogarty catheter was therefore used as a bronchial blocker to achieve selective lung isolation. Under appropriate guidance, the catheter was positioned to occlude the target bronchus, allowing ventilation of the contralateral lung. Careful intraoperative monitoring was performed to detect hypoxemia, airway obstruction, and catheter displacement.

Results: Effective lung isolation was achieved using the Fogarty catheter, providing satisfactory surgical exposure while maintaining adequate oxygenation and ventilation. No major intraoperative respiratory complications occurred.

Conclusion: A Fogarty catheter can be a practical, accessible, and effective alternative for lung isolation in small or malnourished pediatric patients when conventional pediatric OLV devices are unavailable or unsuitable.