One lung Isolation using a Nasogastric tube and Foley’s catheter: A Report of two cases and review

Abstract

Pneumonectomy for suppurative lung disease requires that one-lung anaesthesia be employed to protect the healthy lung from soilage by the diseased lung. The most commonly used technique for achieving lung isolation involves the use of a double lumen tube. However, the use of a double lumen tube especially in children is associated with some challenges hence several other techniques have been described in the literature. The use of a nasogastric tube in achieving one-lung isolation has not been reported in the literature. We report a right pneumonectomy in a 9 year old boy, who aspirated a 4 inch nail into his right tracheobronchial tree complicated by bronchiectasis of the right lung. We made use of a nasogastric tube to drain the secretions in the right lung and a portex endotracheal tube to achieve ventilation of the healthy left lung during the surgical procedure. In the second patient, a Foley’s catheter was used to achieve one lung ventilation in a patient with ruptured giant bullae in the left lung. In the two cases one lung ventilation were successful with no evidence of soilage during the procedure and there were no intraoperative critical events.

Keywords: Pneumonectomy, One-lung anaesthesia, Nasogastric tube, Foley catheter