One Lung Ventilation (OLV) on Needle Evacuation Thoracotomy in Pediatric Patient

Achmad Hariyanto, Muhamad Rizal Hadi Pratama, Eqiel Navadz Akhtar Alami


Background: One lung ventilation (OLV) is a ventilation method that functions to facilitate surgery on one side of the lung to protect one of the lungs from exposure to fluids such as blood, secretions, or foreign bodies. Therefore, it is necessary to place the endrotracheal tube correctly so that complications do not occur. This case report aims to determine the success in surgery using OLV method with blind insertion in pediatric patient.

Case: A 10 years old male patient came to the hospital with complaints of sore throat. Thorax X-Ray photo examination showed that there was a needle-shaped corpus alienum density in the right bronchus branch of the orificium of the right lung. The patient was planned for a needle evacuation thoracotomy using a Double lumen endotracheal-tube (DLT) size 26. The patient was induced using the total intravenous anaesthesia (TIVA) method, ventilation using OLV. The operation was carried out with an incision at the 8th posterolateral intercostal space (ICS) of the dextra deepened layer by layer, the pleura was bluntly penetrated. This surgery went success to extract needle and the patient's condition was stable (HR=104x/min, SpO2=95%). On a third day after surgery, the patient was stable and discharged.

Conclusion: The OLV method using DLT in pediatric patient with blind insertion during thoracotomy showed good results with early mobilization on day 1 after surgery, 3 days of hospital stays, and did not show any serious complication after surgery.  


one lung ventilation; double lumen endotracheal-tube; corpus alineum; thoracotomy;

Full Text:



Bora, V., Kritzmire SM, Arthur ME (2023). Double Lumen Endobronchial Tubes. In StatPearls. StatPearls Publishing.

Fabila TS, Menghraj SJ. One lung ventilation strategies for infants and children undergoing video assisted thoracoscopic surgery. Indian J Anaesth. 2013;57(4):339-344.

Alsharani H, Eldawlatly A. Lung isolation algorithm: A novel template. Saudi J Anaesth. 2014;8:447‑448.

Garg R. Airway management techniques for one lung ventilation in children - what else![J]. Indian J Anaesth. 2014;58(1): 100-101.

Narakusuma, IPF, Kurniyanta P, Aditya W, Aldy. Laporan kasus teknik One Lung Ventilation (OLV) pada anak usia 4 tahun yang menjalani Video Assisted Thoracoscopy Surgery (VATS) bullectomy. Medicina. 2023;54(1):1–4.

Purohit A, Bhargava S, Mangal V, Parashar VK. Lung isolation, one-lung ventilation and hypoxaemia during lung isolation. Indian J Anaesth. 2015;59(9):606–617.

Murray-Torres T, Winch P, Naguib A, Tobias J. Anesthesia for thoracic surgery in infants and children. Saudi J Anaesth. 2021;15(3):283–99.

Giwangkancana G, Andriyanto L, Zulfariansyah A, Lestari AN. One lung ventilation techniques in infants and small children. J Pediatr Surg Case Reports. 2022;82:102314.

de Bellis M, Accardo R, Di Maio M, et al. Is flexible bronchoscopy necessary to confirm the position of double-lumen tubes before thoracic surgery?[J]. Eur J Cardiothorac Surg. 2011; 40(4): 912-916

Kamra SK, Jaiswal AA, Garg AK, et al. Rigid bronchoscopic placement of fogarty catheter as abronchial blocker for one lung isolation and ventilation in infants and children undergoing thoracic surgery: a single institution experience of 27 cases[J]. Indian J Otolaryngol Head Neck Surg. 2017;69(2): 159-171.

Templeton TW, Piccioni F, Chatterjee D. An Update on One-Lung Ventilation in Children. Anesth Analg. 2021;132(5):1389-1399. doi:10.1213/ANE.0000000000005077

Campos JH, Hallam EA, Ueda K. Lung isolation in the morbidly obese patient: a comparison of a left-sided double-lumen tracheal tube with the Arndt wire-guided blocker. Br J Anaesth. 2012; 109(4): 630–635.

El-Tahan M, Doyle DJ, Khidr AM, Hassieb AG. Case Report: Double lumen tube insertion in a morbidly obese patient through the non-channelled blade of the King Vision (™) videolaryngoscope. F1000Res. 2014;3:129. doi:10.12688/f1000research.4481.3

Liu TJ, Shih MS, Lee WL, et al. Hypoxemia during one-lung ventilation for robot-assisted coronary artery bypass graft surgery. Ann Thorac Surg. 2013; 96(1): 127–132.

Marraro GA. Selective bronchial intubation for one-lung ventilation and independent-lung ventilation in pediatric age: State of the art. Chinese J Contemp Pediatr. 2020;22(6):543–554.



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.