Modification of the Murphy’s Eye of a Single-Lumen Endotracheal Tube to Facilitate One-Lung Ventilation in a Child Having a Robotic Sleeve Resection of the Left Bronchus

Anita S. Joselyn et al.

A & A Practice, June 2025

This article discusses a technical modification to improve one-lung ventilation in pediatric patients using a single-lumen endotracheal tube (ETT). Specifically, it addresses the difficulty of right endobronchial intubation due to the short length of the right mainstem bronchus. The conventional approach—aligning the Murphy’s eye with the right upper lobe bronchus—limits how deeply the tube can be inserted, increasing the risk of dislodgement. The authors propose a modification: elongating the Murphy’s eye. This adaptation allows the ETT to be advanced further into the right bronchus while still preserving airflow to the right upper lobe, thereby enhancing tube stability and ventilation safety.

Reference:

Joselyn AS, Manoharan VV, Kisku SM. A & A Practice. 2025 Jun;19(6):e01985. doi:10.1213/XAA.0000000000001985

We would like to thank A & A Practice and the International Anesthesia Research Society (IARS) for allowing us to share this summary. Their continued dedication to advancing pediatric anesthesia practices is greatly appreciated.