Right bevelled tube for selective left bronchial intubation in a child undergoing right thoracotomy.
Left bronchial intubation was used to achieve selective left lung ventilation in a five-year-old child, undergoing thoracotomy for excision of a hydatid cyst of the right lung. Intubation of the left main stem bronchus was easily achieved from the first attempt by a right bevelled tracheal tube. Using a right bevelled tube facilitates left bronchial intubation, since the bevel of the tube faces the right side while its tip lies left to the axis of the trachea. Chest auscultation confirmed selective left lung ventilation. One lung ventilation using 1-2% halothane in 100% oxygen was associated with Spo2 that ranged between 95-97%, and endtidal PETCO2 ranging between 3.9-4.5 kPa (30-35 mmHg). Following excision of the hydatid cyst, the tube was withdrawn above the carina into the trachea, and two lung ventilation was continued until the end of surgery.