| La intubación de la vía aérea pediátrica difícil utilizando fibrobroncoscopio flexible para adultos y una guía de punta-j: Una innovación en la adversidad |
Intubation in a pediatric difficult airway using an adult flexible fiber-optic bronchoscope and a j-tipped guidewire: An innovation in adversity. Naithani M, Jain A, Chaudhary Z. Department of Anaesthesiology, Maulana Azad Institute of Dental Sciences, New Delhi, India. Saudi J Anaesth. 2011 Oct;5(4):414-6Abstract Management of an anticipated difficult airway relies heavily on flexible fiber-optic bronchoscope (FFB) guided awake intubations. In a pediatric patient with difficult airway, doing an awake procedure may be difficult, and hence the child is either deeply sedated or anesthesia is induced before attempting intubation with an appropriate sized FFB. We present the anesthetic management of a 6-year-old child with a lacerated tongue and fractured mandibular condyle, with subsequent inability to open his mouth, who was posted for urgent exploration and open reduction under anesthesia. Unhindered by a damaged pediatric FFB, we innovated by positioning the tip of an adult FFB just outside the larynx, passing a j-tipped guidewire through the working channel of the FFB, and successfully railroaded a naso-tracheal tube over the guidewire. The surgery, reversal and extubation, and the postoperative period were uneventful. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227312/?tool=pubmed |
| Dispositivos supraglóticos para la vía aérea en niños |
Supraglottic airway devices in children.
Ramesh S, Jayanthi R.
Department of Anaesthesia, Senior Consultants, Kanchi Kamakoti Childs Trust Hospital, Chennai, Tamil Nadu, India.
Indian J Anaesth. 2011 Sep;55(5):476-82.
Abstract
Modern anaesthesia practice in children was made possible by the invention of the endotracheal tube (ET), which made lengthy and complex surgical procedures feasible without the disastrous complications of airway obstruction, aspiration of gastric contents or asphyxia. For decades, endotracheal intubation or bag-and-mask ventilation were the mainstays of airway management. In 1983, this changed with the invention of the laryngeal mask airway (LMA), the first supraglottic airway device that blended features of the facemask with those of the ET, providing ease of placement and hands-free maintenance along with a relatively secure airway. The invention and development of the LMA by Dr. Archie Brain has had a significant impact on the practice of anaesthesia, management of the difficult airway and cardiopulmonary resuscitation in children and neonates. This review article will be a brief about the clinical applications of supraglottic airways in children.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237147/?tool=pubmed |
| Técnica de videolaringoscopía para la intubación del recién nacido: informe preliminar |
A videolaryngoscopy technique for the intubation of the newborn: preliminary report.
Vanderhal AL, Berci G, Simmons CF Jr, Hagiike M.
Department of Pediatrics, Division of Neonatology, Minimally Invasive Surgery Research, Cedars-Sinai Medical Center, Los Angeles, California, USA. vanderhala@gmail.com
Pediatrics. 2009 Aug;124(2):e339-46. Epub 2009 Jul 20.
Abstract
OBJECTIVE: We describe videolaryngoscopy equipment and technique for endotracheal intubation and airway evaluation in the delivery room (DR) and NICU for endotracheal intubation and airway evaluation. We report our first experience of 47 patients. METHODS: Forty-seven infants who weighed 530 to 6795 g and required endotracheal intubation or airway evaluation were considered for intubation or assessment by using the modified Kaplan-Berci videolaryngoscope. We report quality-improvement data after initial introduction of newly approved technology. RESULTS: We report results of 48 intubations in 42 patients and videolaryngoscopic inspection without intubation in 5 patients. Five intubation attempts were successful after failed attempts by experienced intubators; 6 attempts by residents were completed with video guidance rather than requiring an additional attempt. Only 3 intubations required more than 2 attempts. Enlarged panoramic view and recording assisted in correct diagnosis of vocal cord paralysis. The features and main advantages are discussed in detail. No complications or difficulties resulting from the technology occurred. CONCLUSIONS: This new technique and technology show promise to improve airway management, evaluation, and teaching. Future research to validate improved intubation success in difficult airways and in teaching situations is warranted.
http://pediatrics.aappublications.org/content/124/2/e339.full.pdf+html |
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