• Madan Mohan Maddali, Mazin Madhaffar Sulaiman Al Wahaibi, Malay Hemantlal Patel, and Sunny Zacharias.
• Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, Oman. Electronic address: madanmaddali@hotmail.com.
• J. Cardiothorac. Vasc. Anesth. 2024 Jan 1; 38 (1): 243247243-247.

AbstractAchieving one-lung ventilation in pediatrics is often challenging. In caring for these patients, the anesthesiologist must consider the child's age and size, underlying tracheobronchial anatomy, equipment availability, urgency of procedure, and as well as the experience level of the anesthesiologist. This report describes a "tube-inside-tube" technique that was adopted for providing one-lung ventilation in a toddler. The method described here involved railroading a smaller endotracheal tube over a flexible intubation video endoscope into the left mainstem bronchus coaxially through a larger endotracheal tube placed in the trachea. The technique achieved effective left-lung ventilation and isolation of the operative right lung during surgical resection of a malignant mesenchymal tumor. On completion of the procedure, double-lung ventilation could be established through the endotracheal tube in the trachea after the retraction of the video endobronchial tube.Copyright © 2023 Elsevier Inc. All rights reserved.

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