Case Report on a 3-year-old Child Who Underwent Video Assisted Thoracoscopy Surgery (VATS) Bullectomy with One Lung Ventilation (OLV) technique

One-lung ventilation (OLV) is a crucial technique used in thoracic surgery, such as lobectomy or pneumonectomy, to isolate one lung and provide optimal surgical exposure while maintaining ventilation. Contrary to the misconception that OLV using Fogarty catheters is not applied in children, this technique is widely used in pediatric anesthesia, particularly during thoracic surgeries. A three-year-old child weighing 15.3 kg presented with a one-week history of coughing and a one-day history of shortness of breath at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar. A chest tube was installed to alleviate tightness, and a thoracic CT scan revealed multiple cavities with consolidation in both inferior lung lobes. The surgeons opted for a bullectomy using the Video-Assisted Thoracoscopic Surgery (VATS) technique. In this case, OLV was achieved using a single-lumen endotracheal tube (ETT) and a Fogarty embolectomy catheter as a bronchial blocker (BB) to replace the fiberoptic bronchoscope (FOB) device. The ballooning-based BB method proved to be an effective alternative for lung isolation. This case demonstrates that using Fogarty catheters for OLV in pediatric thoracic surgery is feasible and effective, highlighting the importance of understanding pediatric and thoracic anesthesia principles to ensure safe and efficient anesthesia care during these procedures, while also addressing the specific dangers and challenges during the perioperative phase.