Assessment and management of the predicted difficult airway in babies and children

Crocker, Kirsty; Black, Ann E.

doi:10.1016/j.mpaic.2009.01.012

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…General anesthesia algorithms for pediatric patients with difficult airways have been published [3]. According to these guidelines, in most pediatric patients, tracheal intubation is performed after the induction of general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Airway Management for Treacher Collins Syndrome with Limited Mouth Opening

Sato

Hanamoto

Kudo

et al. 2013

OJAnes

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Patients with Treacher Collins Syndrome (TCS) present unique airway management problems for anesthesiologists due to mandibular micrognathia, the small oral aperture, and temporomandibular joint anomalies. We describe the case of a pediatric TCS patient with limited mouth opening who experienced severe airway obstruction during deep inhalation anesthesia (sevoflurane following i.v. midazolam) for routine dental work. When difficult airway management is expected, intubation of conscious patients is a well-recognized technique in adults; however, it is rarely appropriate for pediatric patients who usually do not cooperate. According to general anesthesia algorithms for pediatric patients with difficult airways, in most pediatric patients, tracheal intubation is performed after the induction of general anesthesia and some authors have reported the usefulness of LMA for maintaining airway patency in patients with TCS. However, in our case LMA could not be used because of severe limitation of mouth opening. In addition, the LMA is so bulky that it is impossible to insert a LMA into patients with narrow airway anatomy. We initially planned to carry out fiberoptic intubation while awake and under sedation if the airway patency could not be secured after the induction of anesthesia. The patient was sedated properly with midazolam and sevoflurane, and awake fiberoptic intubation was performed uneventfully. Our experience in this case highlighted that careful planning of backup contingencies is important in achieving fiberoptic intubation and maintaining airway patency in pediatric TCS patients with limited mouth opening, and that awake intubation can be successful even in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Airway Management for Treacher Collins Syndrome with Limited Mouth Opening

Sato

Hanamoto

Kudo

et al. 2013

OJAnes

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“…All patients with laryngeal papillomas suffer from anoxia caused by different degrees of laryngeal obstruction. As a result, it is wise to assess whether airway obstruction can threaten life and prepare a plan for the related airway management in advance [12]. This plan should address the anatomy of the respiratory tract, treatment of airway injuries such as bleeding and edema, and how to treat a change from partial airway obstruction to complete one.…”

Section: Discussionmentioning

confidence: 99%

“…There are four ventilation strategies commonly used in endoscopic laryngeal surgery including spontaneous ventilation, mechanical controlled ventilation, apneic intermittent ventilation and subglottic jet ventilation [12]. It is recommendable to keep spontaneous breath during the operation.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia management in pediatric patients with laryngeal papillomatosis undergoing suspension laryngoscopic surgery and a review of the literature

Lin¹,

Wang²,

Shu³

2011

International Journal of Pediatric Otorhinolaryngology

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“…The difficult airway in a child, like an adult, is defined as a patient who is difficult to provide effective bag‐mask ventilation and/or who is challenging to intubate. The definition is often expanded to recognize anatomic and physiologic differences between children and adults . In children, because of their limited cardiorespiratory reserve and the fewer options available for airway management, the definition is often extended to include those children with airway abnormalities who are difficult to intubate using traditional approaches to manage their airway…”

Section: Definition Of the Difficult Pediatric Airwaymentioning

confidence: 99%

Description and function of a difficult airway service

Murray

Massy‐Westropp

Narayana‐Reddy

et al. 2019

Pediatric Anesthesia

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The goal of the Pediatric Difficult Airway Service (DAS) is to improve the care of children with airway abnormalities primarily through identification of children at risk for failed airway management. The airway service encourages early recognition and provides consultation, a plan for airway management, expertise in airway management, and follow‐up care for children who have a difficult airway. The service has improved the education of healthcare professionals and heightened awareness about the consequences of failed airway management.

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Assessment and management of the predicted difficult airway in babies and children

Cited by 11 publications

References 18 publications

Airway Management for Treacher Collins Syndrome with Limited Mouth Opening

Airway Management for Treacher Collins Syndrome with Limited Mouth Opening

Anesthesia management in pediatric patients with laryngeal papillomatosis undergoing suspension laryngoscopic surgery and a review of the literature

Description and function of a difficult airway service

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