Bronchial diameters in children--use of the Fogarty catheter for lung isolation in children.

The right and left main bronchial diameters of 250 children were measured using computed tomography of the thorax. In 75% of the cases, the right main bronchial diameter was significantly larger than the left (95% CI 0.7-0.9, P<0.01). Age but not weight of a child is a good predictor of the bronchial diameter (Beta value is 2.81x10(-2) and 2.58x10(-2) for right and left main bronchial diameter respectively). A size 3 Fogarty catheter will provide effective bronchial blocking for children up to 4 years old. A size 5 Fogarty catheter can be used for most children from 5 to 12 years old. Larger Fogarty catheters or double-lumen tubes can be used in older children. Overinflation of the cuff should be avoided by fibreoptic bronchoscopy of the balloon. Our clinical application of the technique is discussed.