The Role of Selective Balloon Occlusion in Preoperative Planning for Infant Pulmonary Lobar Hyperinflation

To describe balloon catheter occlusion of hyperinflated portions of lung. In six eligible infants, imaging showed severe air trapping from hyperinflated lobes of lung. To determine if surgical removal of the lobe would improve pulmonary function, a catheter was inserted with bedside bronchoscopy. With the balloon inflated, the patient's gas exchange and changes in chest radiograph were monitored. The procedure was technically successful in four of the six infants. Of these four patients, the results were utilized to guide the decision regarding lobectomy in three infants. One patient developed significant hypercarbia during the procedure suggesting that the hyperinflated region of lung was involved in ventilation. In an infant with severe hyperinflation of one or more lobes of the lung, temporary balloon occlusion of the affected lobe may assist decision-making for a lobectomy.