A new method for selective left main bronchus intubation in premature infants.

Unilateral massive pulmonary atelectasis, and pulmonary interstitial emphysema (PIE) are problems that frequently occur in ventilated premature infants. Selective main bronchus intubation (SBI) of the atelectatic lung, or the contralateral lung in unilateral PIE, is an accepted procedure. However, whereas right SBI is usually easily performed, left SBI is frequently difficult. We have developed a method for left SBI using a regular portex endotracheal tube in which an elliptical hole 1 cm in length has been cut through half the circumference 0.5 cm above the tip of the oblique distal end. With the elliptical side hole directed to the left lung, left SBI can easily, and repeatedly be accomplished. This method may prove life saving in certain cases of unilateral atelectasis or PIE.