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Pediatric difficult airway

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https://www.readbyqxmd.com/read/27752382/airway-management-in-a-patient-with-wolf-hirschhorn-syndrome
#1
John F Gamble, Dinesh J Kurian, Andrea G Udani, Nathaniel H Greene
We present a case of a 3-month-old female with Wolf-Hirschhorn syndrome (WHS) undergoing general anesthesia for laparoscopic gastrostomy tube placement with a focus on airway management. WHS is a rare 4p microdeletion syndrome resulting in multiple congenital abnormalities, including craniofacial deformities. Microcephaly, micrognathia, and glossoptosis are common features in WHS patients and risk factors for a pediatric airway that is potentially difficult to intubate. We discuss anesthesia strategies for airway preparation and management in a WHS patient requiring general anesthesia with endotracheal intubation...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27749629/bottle-tongue-entrapment-increasingly-popular-soda-becomes-airway-emergency
#2
Michael T Long, Matthew P Murray
Tongue entrapments within bottles are very rare childhood mishaps. The most immediate hazard in a tongue entrapment is airway obstruction. Tongue entrapment is an airway emergency; contingency planning to maintain airway patency, oxygenation, and ventilation is critical. Here, we report the case of a 5-year-old girl presenting to a pediatric emergency department with an increasingly popular novelty soda bottle, featuring a unique and dangerous design, entrapped on her tongue. Operative removal was anticipated...
September 30, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27749021/is-impaired-glucose-metabolism-the-missing-piece-in-the-obesity-asthma-puzzle
#3
Tarig Ali-Dinar, Jason E Lang
Obesity is a major risk factor for several conditions including atherosclerotic disease, metabolic syndrome, and upper airway dysfunction. However, the purported link between obesity and asthma has remained more difficult to define, in part due to limitations in past epidemiologic studies and the inherent challenge in accurately defining asthma in children. It is possible that obesity leads to asthma only in the presence of a mediating variable such as an obesity-related conditions such as esophageal reflux or insulin resistance...
October 17, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27726001/-perioperative-adverse-respiratory-events-in-overweight-and-obese-children
#4
J Ulrici, G Hempel, M Sasse, J Vollrath, C Höhne
BACKGROUND: Overweight and obesity are increasing problems in pediatric anesthesia. This observational study was designed to examine how airway-related complications occur in overweight children and adolescents during general anesthesia and if this is a relevant problem in Germany. METHODS: From October 2008 until August 2009, at the university clinic in Leipzig, 504 in- and outpatients, aged 2-18 years, ASA I-III, undergoing elective procedures (ENT and pediatric surgery), were observed...
October 10, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27642743/-endotracheal-intubation-in-pediatric-patients
#5
Alexander Humberg, Wolfgang Göpel
Procedure of intubation of children is different to intubation in adults and requires specific considerations. Before intubation management of difficult airway problems should be anticipated. Risk of developing hypoxia is common in children usually due to a reduced apnea tolerance and demands skill of the medical team. Due to soft tissues of the upper airways and the V-shaped epiglottis several laryngoscopes are available. Attention should be kept on a physiological subglottic stenosis, which determines the size of the endotracheal tube...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27530791/-application-of-electronic-bronchoscopy-in-pediatric-intensive-care-patients-with-difficult-ventilator-weaning
#6
Lu Gong, Lan Hu
OBJECTIVE: To investigate the value of electronic bronchoscopy in the etiological diagnosis and treatment of pediatric intensive care patients with difficult ventilator weaning. METHODS: A retrospective analysis was performed for the clinical data of 92 pediatric intensive care patients with difficult ventilator weaning and underwent electronic bronchoscopy. RESULTS: Among all the 92 children, the most common underlying disease was respiratory system disease (39 children)...
August 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/27508129/challenges-in-the-management-of-laryngeal-stenosis
#7
Satish Nair, Ajith Nilakantan, Amit Sood, Atul Gupta, Abhishek Gupta
Laryngeal stenosis is one of the most complex and challenging problems in the field of head and neck surgery. The management involves a multidisciplinary approach with multiple complex procedures. In this study we discuss our experience of laryngeal stenosis with regards to patient characteristics, cause and management. A retrospective analysis of 35 patients of laryngeal stenosis treated at a tertiary care centre was evaluated. Inclusion criteria were all patients with laryngeal stenosis who required surgical intervention...
September 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/27497417/extended-cricotracheal-resection-with-posterior-costochondral-grafting-for-complex-pediatric-subglottic-stenosis
#8
Jaime Penchyna Grub, Enrique Ortíz Hernández, Gustavo Teyssier Morales, Ivan Rivas Rivera, Diego Preciado, Hiram Álvarez-Neri
BACKGROUND AND OBJECTIVE: Severe laryngotracheal stenosis in childhood poses a complex surgical challenge for specialists in airway surgery. Patients with severe subglottic stenosis with vocal cord involvement are particularly difficult to manage successfully. The goal of this work was to review our experience with extended CTR in a cohort of young children with severe SGS and determine which clinical parameters would be associated with surgical success. METHODS: Retrospective analysis of the outcome of consecutive patients with severe glottic-subglottic stenosis submitted to an extended double-stage CTR between 2004 and 2014 at a large tertiary referral center...
September 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27382820/retrograde-intubation-via-laryngeal-mask-airway-in-a-paediatric-patient-with-fallot-type-ventricular-septal-defect-and-cleft-palate-deformity
#9
Taner Ciftci, Serkan Erbatur
We report the case ofa pediatric patient with tetralogy of Fallot (TOF) and cleft palate deformity with difficult intubation in which a laryngeal mask airway (LMA) was used and converted into an endotracheal tube through retrograde intubation. The patient with TOF was scheduled for repair of the congenital bilateral cleft lip and palate. Inhalational induction with 4% sevoflurane was started. Conventional tracheal intubation was impossible because the patient had a difficult airway, and the procedure could cause severe cyanosis and respiratory distress...
February 2016: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/27350350/an-overview-of-perioperative-care-for-pediatric-patients
#10
Sarah Derieg
Care of pediatric surgical patients is not limited to pediatric facilities, and all perioperative RNs should have a basic understanding of the specialized care that children require. This knowledge set includes an understanding of the basic terminology used to describe this patient population as well as the developmental stages of pediatric patients. Preoperatively, the nurse should conduct a thorough assessment and evaluation and address the anxieties and questions of the patient and his or her parent or guardian...
July 2016: AORN Journal
https://www.readbyqxmd.com/read/27276773/simple-timely-safely-laryngeal-mask-and-pediatric-airway
#11
REVIEW
Marijana Karišik
Laryngeal mask airway (LMA) was a useful, powerful airway management device for routine pediatric airway management, pediatric difficult airway, and in pediatric emergency situations. Over years, various designs, induction and insertion techniques have been described. LMA provides ease of placement and removal as compared with endotracheal intubation, less traumatism for the respiratory tract, better tolerability by patients, improved hemodynamic stability during emergency, less coughing, less sore throat, avoidance of laryngoscopy, and hands free airway...
March 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/27276772/fiberoptic-bronchoscopy-versus-video-laryngoscopy-in-pediatric-airway-management
#12
REVIEW
Marijana Karišik, Dušanka Janjević, Massimiliano Sorbello
The primary goal of pediatric airway management is to ensure oxygenation and ventilation. Routine airway management in healthy pediatric patients is normally easy in experienced hands. Really difficult pediatric airway is rare and usually is associated with anatomically and physiologically important findings such as congenital abnormalities and syndromes, trauma, infection, swelling and burns. Using predictors of difficult intubation should be mandatory preoperative assessment in pediatric patients. Difficult airway algorithm for pediatric patients has to consist of three parts: oxygenation (A), tracheal intubation (B), and rescue (C)...
March 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/27240488/endotracheal-tubes-and-the-cricoid-is-there-a-good-fit
#13
Mahmood Rafiq, Tariq M Wani, Melissa Moore-Clingenpeel, Joseph D Tobias
BACKGROUND: Choosing an appropriately sized endotracheal tube (ETT) is important in pediatric patients as an inappropriately sized ETT may result in multiple endotracheal intubation attempts or excessive pressure on the tracheal mucosa with the potential for airway damage. Although age-based formulas are generally used with choice of an ETT based on the internal diameter (ID), measurements of the outer diameter (OD) of the ETT would seem to be a more scientific approach to determine the proper size of an ETT...
June 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27228145/airtraq-laryngoscope-versus-the-conventional-macintosh-laryngoscope-during-pediatric-intubation-performed-by-nurses-a-randomized-crossover-manikin-study-with-three-airway-scenarios
#14
Łukasz Szarpak, Katarzyna Karczewska, Łukasz Czyżewski, Zenon Truszewski, Andrzej Kurowski
OBJECTIVES: We hypothesized that the Airtraq laryngoscope (Airtraq LLC, Bonita Springs, Fla) is beneficial for intubation of pediatric manikins while performing cardiopulmonary resuscitation (CPR). In the present study, we evaluated the effectiveness of the Macintosh (MAC) laryngoscope (HEINE Optotechnik, Munich, Germany) and Airtraq in 3 simulated CPR scenarios. METHODS: A randomized crossover simulation trial was designed. Eighty-three nurses intubated the trachea of a PediaSIM CPR training manikin (FCAE HealthCare, Sarasota, Fla) using the MAC and Airtraq in a normal airway scenario, normal airway with chest compression scenario, and difficult airway with chest compression scenario...
May 25, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27208690/comparison-between-direct-and-video-assisted-laryngoscopy-for-intubations-in-a-pediatric-emergency-department
#15
Matthew A Eisenberg, Israel Green-Hopkins, Heidi Werner, Joshua Nagler
OBJECTIVES: The objective was to compare video-assisted laryngoscopy (VAL) to direct laryngoscopy (DL) on success rate and complication rate of intubations performed in a pediatric emergency department (ED). METHODS: This is a retrospective cohort study of attempted intubations of children aged 0-18 years in a pediatric ED between 2004 and 2014 with first attempt by an ED provider. In VAL, the laryngoscopist attempts direct visualization of the glottis with a C-MAC video laryngoscope while the video monitor is used for real-time guidance by a supervisor, back-up visualization for the laryngoscopist should the direct view be inadequate, and confirmation of endotracheal tube passage through the vocal cords...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27145336/sedation-and-general-anesthesia-for-patients-with-cornelia-de-lange-syndrome-a-case-series
#16
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
https://www.readbyqxmd.com/read/27130327/the-number-of-tracheal-intubation-attempts-matters-a-prospective-multi-institutional-pediatric-observational-study
#17
Jan Hau Lee, David A Turner, Pradip Kamat, Sholeen Nett, Justine Shults, Vinay M Nadkarni, Akira Nishisaki
BACKGROUND: The impact of multiple tracheal intubation (TI) attempts on outcomes in critically ill children with acute respiratory failure is not known. The objective of our study is to determine the association between number of TI attempts and severe desaturation (SpO2 < 70 %) and adverse TI associated events (TIAEs). METHODS: We performed an analysis of a prospective multicenter TI database (National Emergency Airway Registry for Children: NEAR4KIDS)...
2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27083381/a-comparison-of-the-truview-pcd-and-the-glidescope-cobalt-avl-video-laryngoscopes-to-the-miller-blade-for-successfully-intubating-manikins-simulating-normal-and-difficult-pediatric-airways
#18
Helena K Hippard, Govindan Kalyani, Olutoyin A Olutoye, David G Mann, Mehernoor F Watcha
BACKGROUND: Video-laryngoscopes provide better glottic visualization, but tracheal intubation times are longer, compared to conventional direct laryngoscopy in adult patients with normal airways. The objective of this randomized crossover study was to compare times to successful tracheal intubation with video-laryngoscope and direct laryngoscopy in manikins simulating infants with normal and abnormal airways. METHODS: Thirty experienced pediatric anesthesia practitioners performed tracheal intubation in three distinct manikins simulating infants with (i) a normal airway (ii), an anterior larynx, and (iii) the Pierre Robin sequence anatomy...
June 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27071070/cardiac-arrests-associated-with-tracheal-intubations-in-picus-a-multicenter-cohort-study
#19
Yuko Shiima, Robert A Berg, Hillary R Bogner, Knashawn H Morales, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: To determine the incidence and epidemiologic characteristics of cardiac arrests among tracheal intubations in PICUs. DESIGN: Retrospective cohort study of prospectively collected data. SETTING: Twenty-five diverse PICUs. PATIENTS: Critically ill children requiring tracheal intubation in PICUs. INTERVENTIONS: Tracheal intubation quality improvement data were prospectively collected for all initial tracheal intubations in 25 PICUs from July 2010 to March 2014 using National Emergency Airway Registry for Children registry...
September 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27063343/cervical-hematoma-following-an-endocrine-surgical-procedure-the-md-anderson-experience
#20
Ioannis A Christakis, Elena Potylchansky, Angelica M Silva, Joseph P Nates, Peter A Prieto, Paul H Graham, Elizabeth G Grubbs, Jeffrey E Lee, Nancy D Perrier
BACKGROUND: Airway compromise from postoperative neck hematoma remains the most feared complication after cervical endocrine operative procedures. Events are rare and potentially lethal, and clear multidisciplinary guidelines for management of these patients are lacking. The aim of our study was to review the experience of a tertiary cancer center in this scenario. METHODS: Data prospectively collected over a 10-year period, between 2005 and 2014, were retrospectively analyzed...
August 2016: Surgery
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