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pediatric airway management

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https://www.readbyqxmd.com/read/29889726/evolution-of-delivery-room-management-for-meconium-stained-infants-recent-updates
#1
Shilpi Chabra
BACKGROUND: The approach to intrapartum and postnatal management of an infant born through meconium-stained amniotic fluid (MSAF) in the delivery room (DR) has changed several times over the last few decades, leading to confusion and anxiety among health care providers (nurses, nurse practitioners, respiratory therapists, midwives, and physicians). This article provides state-of-the-art insight into the evidence or lack thereof for the changes in guidelines. PURPOSE: To discuss the evidence for evolution of DR management of vigorous and nonvigorous infants born through any type of MSAF...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29876333/pediatric-inflammatory-myofibroblastic-tumors-of-the-airway-two-case-reports-with-varying-clinical-presentation
#2
Nuthan Kumar, Thirunavukkarasu Saravanamuthu, Arathi Srinivasan, Thulasi Raman, Julius-Xavier Scott
Introduction: An inflammatory myofibroblastic tumor (IMT) is a rare tumor of intermediate malignant potential. It may occur in a wide range of anatomical locations. One-third are found in the respiratory tract. We report two cases of IMT of the airway diagnosed at our institution. Case Report: Case 1: A 6-year-old male child presented with a 1-month history of hoarseness of the voice. On evaluation, a polypoid nodule was noted in the right vocal cord which was excised through the endolaryngeal route...
May 2018: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29873601/unique-challenges-to-the-approach-and-management-of-pediatric-headscarf-pin-aspiration
#3
Shadi Hamouri, Faisal Swesi, Nathan Michael Novotny
BACKGROUND: Headscarf use is becoming more common throughout the world. Many articles describe the problem of aspirated headscarf pins but few if any give technical details for retrieval or innovative methods of removal if traditional bronchoscopy fails particularly in the pediatric population. Herein, we describe our method of deep sedation with laryngeal mask airway (LMA) and flexible bronchoscopy (FB) and retrieval with a stepwise algorithm if traditional FB fails. METHODS: A retrospective review of pediatric patients with aspirated headscarf pins was performed...
June 6, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29871002/erratum-to-current-management-of-congenital-pulmonary-airway-malformations-a-european-pediatric-surgeons-association-survey
#4
Francesco Morini, Augusto Zani, Andrea Conforti, Ernest van Heurn, Simon Eaton, Prem Puri, Risto Rintala, Marija Lukac, Joachim F Kuebler, Florian Friedmacher, Rene Wijnen, Juan Antonio Tovar, Agostino Pierro, Pietro Bagolan
No abstract text is available yet for this article.
June 5, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29861210/flexible-bronchoscopic-findings-and-the-relationship-to-repeated-extubation-failure-in-critical-children
#5
Yu-Ting Lin, Yu-Sheng Lee, Mei-Jy Jeng, Wei-Yu Chen, Pei-Chen Tsao, I-Ching Chan, Wen-Jue Soong
BACKGROUND: Extubation failure (EF) in acute pediatric cases causes high morbidity and prolonged hospitalization, some of which might encounter EF repeatedly. This study aims to investigate flexible bronchoscopic findings of airway problems associated with repeated EF (REF) in children. METHODS: We retrospectively reviewed the medical records of intubated children from 2005 to 2013 and enrolled those with EF (reintubated within 48 h after extubation) and receiving flexible bronchoscopy (FB) examinations...
May 31, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29851190/choosing-wisely-in-pediatric-anesthesia-an-interpretation-from-the-german-scientific-working-group-of-paediatric-anaesthesia-wakka
#6
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
May 30, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29799085/venoarterial-extracorporeal-membrane-oxygenation-support-for-neonatal-and-pediatric-refractory-septic-shock-more-than-15-years-of-learning
#7
Anna Solé, Iolanda Jordan, Sara Bobillo, Julio Moreno, Monica Balaguer, Lluisa Hernández-Platero, Susana Segura, Francisco José Cambra, Elisabeth Esteban, Javier Rodríguez-Fanjul
The objective of the study was to report our institutional experience in the management of children and newborns with refractory septic shock who required venoarterial extracorporeal membrane oxygenation (VA ECMO) treatment, and to identify patient-and infection-related factors associated with mortality. This is a retrospective case series in an intensive care unit of a tertiary pediatric center. Inclusion criteria were patients ≤ 18 years old who underwent a VA ECMO due to a refractory septic shock due to circulatory collapse...
May 24, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29743805/outcomes-after-endoscopic-dilation-of-laryngotracheal-stenosis-an-analysis-of-acs-nsqip
#8
Avni Bavishi, Emily Boss, Rahul K Shah, Jennifer Lavin
Importance: Endoscopic management of pediatric subglottic stenosis (SGS) is common, however no multi-institutional studies have assessed its perioperative outcomes. The American College of Surgeon's National Surgical Quality Improvement Program - Pediatric (ACS-NSQIP-P) represents a source of such data. Design: Current procedural terminology (CPT) codes were queried for endoscopic or open airway reconstruction in the ACS-NSQIP-P Public Use File (PUF). Demographics and 30-day events were abstracted to compare open to endoscopic techniques and to assess for risk factors for varied outcomes after endoscopic dilation...
March 2018: Journal of Clinical Outcomes Management: JCOM
https://www.readbyqxmd.com/read/29717916/risk-factors-associated-with-the-development-of-acquired-airway-disease-after-congenital-heart-surgery-a-retrospective-cohort-study
#9
Andrew J Matisoff, Pranathi Ari, David Zurakowski, Alexandra G Espinel, Nina Deutsch, Brian K Reilly
OBJECTIVE: In this single-center, retrospective review, we sought to determine the risk factors associated with the development of severe acquired airway disease (AAD; vocal cord paralysis [VCP] or subglottic stenosis [SGS]) in pediatric patients who had undergone surgery for congenital heart disease (CHD) with cardiopulmonary bypass. All patients who required surgical treatment for CHD using cardiopulmonary bypass at our institution between 2010 and 2015 were reviewed. We defined severe AAD as either clinically significant VCP, SGS, or both, requiring consultation with the otolaryngology (ENT) service for evaluation...
April 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29709387/the-fork-in-the-road-a-laryngeal-filter-airway-foreign-body
#10
Jacob E Kuperstock, J Pieter Noordzij
OBJECTIVE: Upper aero-digestive tract foreign body management can be complicated and life threatening in both adult and pediatric populations. The variation seen with foreign bodies including shape, material, and duration of ingestion can impact clinical decision making and management. The objective of this report is to demonstrate a complicated case of upper airway obstruction by a plastic fork. METHOD: This case report presents an adult with ingestion of an intact plastic fork with acute laryngeal and cervical esophageal obstruction...
April 18, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29697466/perioperative-considerations-for-airway-management-and-drug-dosing-in-obese-children
#11
Jerrold Lerman, Karin Becke
PURPOSE OF REVIEW: Childhood obesity, a phenomenon that is increasing globally, holds substantial relevance for pediatric anesthesia. In particular, understanding the nuances of airway management and drug dosing in obese children can be daunting. RECENT FINDINGS: Respiratory adverse events and challenges in managing the airway may be anticipated. In addition, drug-dosing strategies for the obese child are complex and poorly understood although recent advances have clarified the optimal dosing for anesthetics in these children...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29687659/effectiveness-and-safety-of-nasal-mask-versus-binasal-prongs-for-providing-continuous-positive-airway-pressure-in-preterm-infants-a-systematic-review-and-meta-analysis
#12
REVIEW
Bonny Jasani, Abu Ismail, Shripada Rao, Sanjay Patole
Continuous positive airway pressure (CPAP) delivered via binasal prongs has been the cornerstone of respiratory management in preterm infants. Though effective, the use of binasal prongs is associated with nasal trauma, and CPAP failure. To overcome these issues, nasal masks are increasingly used to deliver CPAP in preterm infants. The aim was to conduct a systematic review of randomized controlled trials (RCTs) comparing nasal mask versus binasal prongs to deliver CPAP in preterm infants. Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing, and Allied Health Literature, and E-abstracts from the Pediatric Academic Society meetings were searched in May 2017...
April 23, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29687523/safety-of-anesthesia-for-children-with-mucopolysaccharidoses-a-retrospective-analysis-of-54-patients
#13
Vittorio Scaravilli, Alberto Zanella, Valentina Ciceri, Mariagrazia Bosatra, Claudia Flandoli, Alessia La Bruna, Simone Sosio, Rossella Parini, Serena Gasperini, Antonio Pesenti, Alessandra Moretto
BACKGROUND: Complications are common during anesthesia for patients with mucopolysaccharidoses. San Gerardo Hospital (Italy) is a reference center for mucopolysaccharidoses with a dedicated pediatric anesthesia service. AIMS: This study aims to evaluate the safety of anesthesia for mucopolysaccharidoses patients, describe their anesthetic management at our institution, and assess risk factors for complications. METHODS: The anesthetic charts of mucopolysaccharidoses patients admitted from January 1999 to December 2014 were retrospectively analyzed...
May 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29652686/massive-macroglossia-after-posterior-cranial-fossa-surgery-a-case-report
#14
Jennifer F Ha, Lisa N Vitale, Marie A Pfarr, Yu Kawai, David A Zopf
A 16-year-old boy with Chiari 1 malformation presented for an elective suboccipital craniectomy and C1 laminectomy. His intraoperative course was uneventful. At the conclusion of the procedure, he met extubation criteria and followed commands. After extubation, he developed progressive upper airway obstruction and became obtunded. He was reintubated via videolaryngoscopy, which showed edema not only to the tongue, but also to the posterior pharynx and blisters over the vocal folds and epiglottis. The patient was transferred to the pediatric intensive care unit intubated and sedated...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#15
Shemila Abbasi, Fauzia Anis Khan, Sobia Khan
Background and Aims: The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Material and Methods: Incidents related to pediatric population from neonatal period till the age of 12 years were selected...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628599/temporomandibular-joint-ankylosis-a-pediatric-difficult-airway-management
#16
Anoop Sharma, Deepak Dwivedi, Ram Murti Sharma
Intubating a pediatric patient with temporomandibular joint ankylosis is a daunting task, and it becomes more challenging with limited mouth opening. Fiberoptic nasotracheal intubation technique is considered a gold standard. We describe an improvised technique of securing airway in the absence of appropriate-sized fiberoptic scope. The endotracheal tube inserted in the left nostril for maintaining depth of anesthesia was advanced under vision by the fiberoptic scope inserted into the right nostril, and with external laryngeal manipulation, the airway was secured with no complications...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29625664/challenges-in-the-treatment-of-asthma-in-children-and-adolescents
#17
REVIEW
Stanley J Szefler, Bradley Chipps
OBJECTIVE: Despite the availability of effective treatments, asthma control in children and adolescents remains inadequate and rates of health care use are high. This follow-up to a recent review (O'Byrne et al, Eur Respir J. 2017;50[3]) examines a number of challenges in current pediatric asthma management compared with that of an adult perspective and discusses possible alternative strategies that might improve pediatric asthma management and control. DATA SOURCES: The evidence base for this review is limited because, historically, much of the research has been performed in adults...
April 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29622333/emergency-care-of-pediatric-burns
#18
REVIEW
Ashley M Strobel, Ryan Fey
Although the overall incidence of and mortality rate associated with burn injury have decreased in recent decades, burns remain a significant source of morbidity and mortality in children. Children with major burns require emergent resuscitation. Resuscitation is similar to that for adults, including pain control, airway management, and administration of intravenous fluid. However, in pediatrics, fluid resuscitation is needed for burns greater than or equal to 15% of total body surface area (TBSA) compared with burns greater than or equal to 20% TBSA for adults...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29622331/postoperative-tonsillectomy-hemorrhage
#19
REVIEW
Jessica J Wall, Khoon-Yen Tay
Post-tonsillectomy hemorrhage represents a potentially life-threatening condition that occurs in up to 5% of pediatric patients. Minor bleeding often precedes severe hemorrhage. Patients with minor or self-resolving bleeding should be observed in the emergency department or admitted for monitoring. Patients with severe bleeding should be immediately assessed for airway and hemodynamic stability. Management of severe bleeding includes immediate surgical consultation or initiation of the transfer process to a center with surgical capabilities, direct pressure to the site of hemorrhage with or without the additional of a hemostatic agent, possible rapid sequence intubation, and management of hemodynamic instability with volume resuscitation...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29622330/pediatric-ventilator-management-in-the-emergency-department
#20
REVIEW
Garrett S Pacheco, Jenny Mendelson, Mary Gaspers
Pediatric mechanical ventilation is first initiated by emergency physicians when performing active airway management in a critically ill or injured child. When initiating and adjusting mechanical ventilation, the child has unique anatomy and physiology to consider. The EP is the first to respond to ventilator alarm triggers, and the initial medical provider to resuscitate the ventilated pediatric patient who is deteriorating while in the emergency department. This article uses cases to provide a framework to initiate and troubleshoot mechanical ventilation of pediatric patients in the emergency department...
May 2018: Emergency Medicine Clinics of North America
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