Patient Age Selection
6 months - 1 year
6m
2y
4y
6y
8y
10y
12y
14y
16y
18y
Single-Lumen ETT
3.5 - 4.0
mm ID
- Simplest technique, good for emergencies.
- Cannot suction operated lung.
- Risk of upper lobe obstruction.
Bronchial Blocker
5
Fr
Balloon-tipped / Wire-guided
- Versatile; seal is predictable.
- Risk of tracheal dislodgement.
- Scope Check: 5 Fr Blocker + 2.5mm Scope requires ETT ≥ 5.0mm ID.
Univent Tube
-
mm ID
Torque Control Blocker
- Stable blocker positioning.
- High airflow resistance in small sizes.
- Large outer diameter.
Double-Lumen Tube
-
Fr
- Best isolation; allows suction/CPAP.
- Limited sizing (usually >8 years).
- Left DLT preferred (Right DLT risks RUL obstruction).
Clinical Pearl: Lateral Decubitus Positioning
Infants
Healthy Lung UP
Soft ribs & low FRC cause airway closure if dependent.
Adults
Healthy Lung DOWN
Hydrostatic pressure improves perfusion to dependent lung.
"In infants with unilateral disease, oxygenation is improved with the healthy lung up... [unlike] the adult patient." (Hammer, p.2)