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pediatric bronchoscopy anesthesia

Hongquan Zhang, Baojun Fang, Wenjing Zhou
Flexible bronchoscopy has been more and more used for diagnosis and management diseases of respiratory system in pediatrics. Previous studies have reported that remifentanil (RF) and propofol are safe and effective for flexible bronchoscopy in adults, however, there have no trials evaluate the efficacy of DEX-RF versus dexmedetomidine-propofol in children undergoing flexible bronchoscopy.We divided 123 children undergoing flexible bronchoscopy with DEX-RF or dexmedetomidine-propofol into 2 groups: Group DR (n = 63, DEX infusion at 1...
January 2017: Medicine (Baltimore)
Mustafa Azizoglu, Handan Birbicer, Suleyman Memis, Hakan Taşkınlar
Sugammadex is a selective chemical agent that can reverse neuromuscular blockade induced by vecuronium and rocuronium. The aim of this report is to discuss the effectiveness of sugammadex in the reversal of neuromuscular blockade in children younger than 2 years. A 16-month-old boy, weighing 10 kg, was admitted to the pediatric emergency department due to choking, cyanosis, and severe respiratory distress that occurred while he was eating peanuts. In the emergency department, the patient's condition deteriorated, and he went into respiratory arrest...
September 2016: Journal of Clinical Anesthesia
Samia Hamouda, Amal Oueslati, Imen Belhadj, Fatma Khalsi, Faten Tinsa, Khadija Boussetta
OBJECTIVE: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children's respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia. METHODS: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014. RESULTS: We performed 365 FB in 333 patients aged 46 months on average (1 month - 15 years), often under conscious anesthesia (81...
March 2016: African Health Sciences
Tara L Wenger, John Dahl, Elizabeth J Bhoj, Anna Rosen, Donna McDonald-McGinn, Elaine Zackai, Ian Jacobs, Carrie L Heike, Anne Hing, Avni Santani, Andrew F Inglis, Kathleen C Y Sie, Michael Cunningham, Jonathan Perkins
PURPOSE: Because a tracheal cartilaginous sleeve (TCS) confers a significant mortality risk that can be mitigated with appropriate intervention, we sought to describe the prevalence and associated genotypes in a large cohort of children with syndromic craniosynostosis. METHODS: Chart review of patients with syndromic craniosynostosis across two institutions. RESULTS: In a cohort of 86 patients with syndromic craniosynostosis, 31 required airway evaluation under anesthesia...
May 26, 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Alessandra Moretto, Vittorio Scaravilli, Valentina Ciceri, Mariagrazia Bosatra, Federica Giannatelli, Bianca Ateniese, Milena Mariani, Anna Cereda, Simone Sosio, Alberto Zanella, Antonio Pesenti, Angelo Selicorni
Cornelia De Lange syndrome (CdLS) is a rare congenital disease characterized by typical facial dysmorphism, developmental disability, and limb deficiency defects. Various congenital malformations and medical complications have been described with gastroesophageal reflux as the major one. CdLS patients often require multiple high-risk anesthetic procedures. At San Gerardo Hospital (Monza, Italy) the management of CdLS patients is routinely organized through a standard protocol and a dedicated pediatric anesthesia team has been implemented...
June 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
Eelam Adil, Ozgul Gergin, Kosuke Kawai, Reza Rahbar, Karen Watters
IMPORTANCE: There is no consensus on the evaluation of pediatric patients with aspiration. OBJECTIVES: To determine the yield of direct laryngoscopy and bronchoscopy (DLB) using general anesthesia in pediatric patients who aspirate and to identify clinical predictors of aspiration-related airway lesions. DESIGN, SETTING, AND PARTICIPANTS: Retrospective review at a tertiary referral children's hospital. A medical record review was performed on all patients with a documented diagnosis of pulmonary aspiration who underwent DLB using general anesthesia during a 5-year period (January 2010 to December 2014)...
April 2016: JAMA Otolaryngology—Head & Neck Surgery
Eelam Adil, Hasan Al Shemari, Amy Kacprowicz, Jennifer Perez, Kara Larson, Kayla Hernandez, Kosuke Kawai, Julia Cowenhoven, David Urion, Reza Rahbar
IMPORTANCE: Chronic airway aspiration is a challenging problem for physicians and caregivers and can cause significant pulmonary morbidity in pediatric patients. Our knowledge regarding the causes and optimal management of these patients is in its infancy. OBJECTIVE: To review our experience with the evaluation and management of pediatric patients with documented aspiration and normal upper airway anatomy. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective medical record review, we studied pediatric patients for airway disorders at a pediatric tertiary referral center who were diagnosed as having aspiration on modified barium swallow study during a 10-year period (June 1, 2002, through September 31, 2012)...
November 2015: JAMA Otolaryngology—Head & Neck Surgery
Mitchell D Barneck, J Taylor Webb, Ryan E Robinson, J Fredrik Grimmer
OBJECTIVES/HYPOTHESIS: Observed complications during rigid bronchoscopy, including hypercarbia and hypoxemia, prompted us to assess how well rigid bronchoscopes serve as an airway device. We performed computer-aided design flow analysis of pediatric rigid bronchoscopes to gain insight into flow dynamics. STUDY DESIGN: We made accurate three-dimensional computer models of pediatric rigid bronchoscopes and endotracheal tubes. SOLIDWORKS (Dassault Systemes, Vélizy-Villacoublay, France) flow analysis software was used to analyze fluid dynamics during pressure-controlled and volume-controlled ventilation...
August 2016: Laryngoscope
Brandon Esenther, Riva Ko
A 4-year-old boy presented for elective bronchoscopy after years of pharmacologically unresponsive reactive airway disease that limited physical activity. After mask induction with nitrous oxide and sevoflurane, the patient was noted to be intermittently in a hemodynamically stable tachyarrhythmia. The anesthesia machine, though equipped with electrocardiogram (ECG) recording capabilities, malfunctioned during the case and was not able to print a rhythm strip. As a substitute, a smartphone picture and video were recorded...
August 1, 2015: A & A Case Reports
Steven M Andreoli, Emma Kofmehl, Steven E Sobol
OBJECTIVE: To determine the need for postoperative admission following airway foreign body retrieval by examining the preoperative presentation, operative details, and postoperative recovery. INTRODUCTION: Inpatient admission following foreign body removal is common, however little evidence supports this practice. In the era of cost containment and prudent utilization of hospital resources, careful examination of the postoperative course following airway foreign body removal is required...
September 2015: International Journal of Pediatric Otorhinolaryngology
Yann Lelonge, François Varlet, Patricio Varela, Francisco Saitúa, Laurent Fourcade, Rocio Gutierrez, Sophie Vermesch, Jean-Michel Prades, Manuel Lopez
OBJECTIVE: Recurrent tracheoesophageal fistula (RTEF) is a serious complication after primary repair of esophageal atresia and tracheoesophageal fistula (EA/TEF). Treatment of RTEF involved an open surgery by thoracotomy. Technically it is a challenge with a high morbidity and mortality. Congenital tracheoesophageal fistula (CTEF) traditionally involved an open surgery by thoracotomy or cervicotomy. Many endoscopic techniques have been developed since the past decades: thoracoscopic or bronchoscopic approach for the treatment of RTEF and CTEF; nevertheless, optimal treatment is not still determined because of few numbers of patients, short-term follow-up, and different procedures...
April 2016: Surgical Endoscopy
Assaad Kesrouani, Georges Dabar, Samir Rahal, Claude Ghorra
Mucoepidermoid carcinoma of the tracheobronchial tree is a rare airway tumor (<1% of all lung tumors). In adults, the majority of primary tracheal tumors are malignant. Management during pregnancy is complex and requires weighing maternal and fetal prognosis. Reported cases describe surgical resection following cesarean section. We report the first case to be treated by Argon-Plasma Coagulation (APC) in pregnancy. A 35-year-old Caucasian woman G1P0, at 27 weeks of gestation was admitted to the emergency department because of hemoptysis and severe dyspnea...
May 2015: International Surgery
Monawat Ngerncham, Edward Y Lee, David Zurakowski, Donald A Tracy, Russell Jennings
PURPOSE: Diagnostic laryngoscopy and bronchoscopy (DLB) has been the traditional preoperative diagnostic modality for evaluating presence and severity of tracheobronchomalacia (TBM), and requires anesthesia. Alternatively, multidetector computed tomography (MDCT) is potentially a noninvasive modality that provides high-resolution, 3-dimensional (3D) imaging of the thorax providing preoperative guidance for pediatric surgeons. This study compares MDCT with intraoperative DLB in the assessment of TBM in symptomatic pediatric patients with esophageal atresia (EA)...
March 2015: Journal of Pediatric Surgery
Sarah L Prunty, Alberto Aranda-Palacios, Andy M Heard, Gordon Chapman, Anoop Ramgolam, Mary Hegarty, Shyan Vijayasekaran, Britta S von Ungern-Sternberg
BACKGROUND: While the majority of pediatric intubations are uncomplicated, the 'Can't intubate, Can't Oxygenate' scenario (CICO) does occur. With limited management guidelines available, CICO is still a challenge even to experienced pediatric anesthetists. OBJECTIVES: To compare the COOK Melker cricothyroidotomy kit (CM) with a scalpel bougie (SB) technique for success rate and complication rate in a tracheotomy on a cadaveric 'infant airway' animal model. METHODS: Two experienced proceduralists repeatedly attempted tracheotomy in eight rabbits, alternately using CM and SB (4 fr) technique...
April 2015: Paediatric Anaesthesia
Eelam Adil, Hasan Al Shemari, Reza Rahbar
IMPORTANCE: Type 3 laryngeal clefts (LC type 3) are traditionally repaired through an open approach, which requires tracheal intubation or tracheotomy placement and risks potential wound complications. OBJECTIVE: To describe the surgical technique and outcomes of endoscopic carbon dioxide laser-assisted repair in pediatric patients with LC type 3. DESIGN, SETTING, AND PARTICIPANTS: Retrospective medical record review of 6 patients with LC type 3, diagnosed via direct laryngoscopy and rigid bronchoscopy, from January 2007 to September 2013, at a tertiary pediatric hospital...
November 2014: JAMA Otolaryngology—Head & Neck Surgery
A Boufersaoui, L Smati, K N Benhalla, R Boukari, S Smail, K Anik, R Aouameur, H Chaouche, M Baghriche
OBJECTIVES: The objective of this study was to analyze the epidemiological, clinical, radiological, and endoscopic characteristics of pediatric foreign body aspiration in Algeria. METHODS: In this retrospective study, the results of 2624 children younger than 18 years admitted to our department for respiratory foreign body removal between 1989 and 2012 were reviewed. Most of them underwent ambulatory rigid bronchoscopy. RESULTS: The children (62 males [34%] and 37 [65%] females) were aged 4 months to 18 years with 66% between 1 and 3 years of age...
August 19, 2014: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Joshua H Atkins, Jeff E Mandel, Giulia Rosanova
BACKGROUND: Drug-induced sleep endoscopy (DISE) uses sedative-hypnotics to induce moderate obstruction in sleep apnea patients, thereby facilitating anatomic assessment of obstructive physiology. Implementation of DISE with propofol requires a dosing strategy that reliably and efficiently produces obstruction while minimizing oxygen desaturation. METHODS: The surgeon in a prospective study of transoral robotic resection of the tongue base enrolled 97 patients with obstructive sleep apnea confirmed by polysomnography who failed continuous positive airway pressure...
October 2014: Anesthesia and Analgesia
Mefkur Bakan, Ufuk Topuz, Tarik Umutoglu, Gokhan Gundogdu, Zekeriya Ilce, Mehmet Elicevik, Guner Kaya
OBJECTIVE: Laryngoscopy and stimuli inside the trachea cause an intense sympatho-adrenal response. Remifentanil seems to be the optimal opioid for rigid bronchoscopy due to its potent and short-acting properties. The purpose of this study was to compare bolus propofol and ketamine as an adjuvant to remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy. MATERIALS AND METHODS: Forty children under 12 years of age who had been scheduled for a rigid bronchoscopy were included in this study...
June 2014: Clinics
Don Hayes, Aymen Naguib, Stephen Kirkby, Mark Galantowicz, Patrick I McConnell, Peter B Baker, Benjamin T Kopp, Eric A Lloyd, Todd L Astor
BACKGROUND: Limited data exist on methods to evaluate allograft function in infant recipients of lung and heart-lung transplants. At our institution, we developed a procedural protocol in coordination with pediatric anesthesia where infants were sedated to perform infant pulmonary function testing, computed tomography imaging of the chest, and flexible fiberoptic bronchoscopy with transbronchial biopsies. METHODS: A retrospective review was performed of children aged younger than 1 year who underwent lung or heart-lung transplantation at our institution to assess the effect of this procedural protocol in the evaluation of infant lung allografts...
May 2014: Journal of Heart and Lung Transplantation
K Chen, X Shen
PURPOSE: To detail our experience using dexmedetomidine in combination with propofol for airway foreign body removal in spontaneously breathing patients. CLINICAL FEATURES: Dexmedetomidine and propofol intravenous anesthesia as a primary anesthetic was used for three pediatric patients with severe respiratory impairment due to foreign body aspiration and two elderly patients requiring airway foreign body removal by rigid bronchoscopy. All patients were spontaneously ventilating, and had successful airway foreign body removal without severe hypoxemia...
September 2014: Irish Journal of Medical Science
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